MEDICARE: TROY SPEECH THERAPY, LLC

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	SP6710	OH

General Provider Information

NPI Number	:	1346601994
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TROY SPEECH THERAPY, LLC

Provider Business Mailing Address
First Line	:	41 ROBIN HOOD LN
Second Line	:
City	:	TROY
State	:	OH
Zip	:	45373-1526
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	41 ROBIN HOOD LN
Second Line	:
City	:	TROY
State	:	OH
Zip	:	45373-1526
Country	:	US
Telephone Number	:	937-570-4908
Fax Number	:

Authorized Official
Title or Position	:	OWNER/ SPEECH THERAPIST
Name	:	COURTNEY LOMBARDO
Credential	:	SLP
Telephone Number	:	937-570-4908

Provider Enumeration Date	:	03/10/2016
Last Update Date	:	03/10/2016

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Directions to “TROY SPEECH THERAPY, LLC ” Practice Location

Language	Start Address	Practice Location

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