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NPI Code Detail

MEDICARE: LAURA MCDOUGLE MACCC-SLP

MEDICARE: LAURA MCDOUGLE MACCC-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
1235Z00000XSpeech-Language PathologistSP6797OH

General Provider Information

NPI Number : 1316362486
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA MCDOUGLE MACCC-SLP
Provider Business Mailing Address
First Line : 2226 COUNTY ROAD U
Second Line :
City : LIBERTY CENTER
State : OH
Zip : 43532-9123
Country : US
Telephone Number : 419-832-2750
Fax Number :
Provider Business Practice Location Address
First Line : 401 W AIRPORT HWY
Second Line :
City : SWANTON
State : OH
Zip : 43558-1445
Country : US
Telephone Number : 419-825-1111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/26/2014
Last Update Date : 02/26/2014

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Directions to “ LAURA MCDOUGLE MACCC-SLP” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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