MEDICARE: MRS. MAUREEN RAE NALL 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
2	235Z00000X	Speech-Language Pathologist	100163	TX

General Provider Information

NPI Number	:	1346468998
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MAUREEN RAE NALL M.A., CCC-SLP

Provider Business Mailing Address
First Line	:	3902 ARROWCREST LN
Second Line	:
City	:	GARLAND
State	:	TX
Zip	:	75044-6010
Country	:	US
Telephone Number	:	972-836-2098
Fax Number	:	972-485-0486

Provider Business Practice Location Address
First Line	:	805 PLEASANT VALLEY RD
Second Line	:
City	:	GARLAND
State	:	TX
Zip	:	75040-4834
Country	:	US
Telephone Number	:	972-494-8311
Fax Number	:

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

Provider Enumeration Date	:	04/20/2007
Last Update Date	:	07/01/2022

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Directions to “ MRS. MAUREEN RAE NALL M.A., CCC-SLP” Practice Location

Language	Start Address	Practice Location

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