MEDICARE: LAURA BADGER M.S. 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	8380	MA

General Provider Information

NPI Number	:	1427489632
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA BADGER M.S. CCC-SLP

Provider Business Mailing Address
First Line	:	11 MENOTOMY RD
Second Line	:
City	:	ARLINGTON
State	:	MA
Zip	:	02476-6109
Country	:	US
Telephone Number	:	845-518-5365
Fax Number	:

Provider Business Practice Location Address
First Line	:	11 MENOTOMY RD
Second Line	:
City	:	ARLINGTON
State	:	MA
Zip	:	02476-6109
Country	:	US
Telephone Number	:	845-518-5365
Fax Number	:

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

Provider Enumeration Date	:	12/13/2013
Last Update Date	:	01/20/2014

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