MEDICARE: SUZANNE HELFRICH FEAGAN M.A. CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	2005029533	MO

General Provider Information

NPI Number	:	1235283896
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUZANNE HELFRICH FEAGAN M.A. CCC-SLP

Provider Business Mailing Address
First Line	:	1320 GREEN TREE LN
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63122-4745
Country	:	US
Telephone Number	:	314-477-4343
Fax Number	:

Provider Business Practice Location Address
First Line	:	1320 GREEN TREE LN
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63122-4745
Country	:	US
Telephone Number	:	314-477-4343
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/22/2007
Last Update Date	:	09/28/2016

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Directions to “ SUZANNE HELFRICH FEAGAN M.A. CCC-SLP” Practice Location

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