MEDICARE: SYDNEY EUCHNER MS, 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	077932	IA

General Provider Information

NPI Number	:	1467097097
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SYDNEY EUCHNER MS, CCC-SLP

Provider Business Mailing Address
First Line	:	107 8TH ST
Second Line	:
City	:	VAN HORNE
State	:	IA
Zip	:	52346-9894
Country	:	US
Telephone Number	:	319-230-7796
Fax Number	:

Provider Business Practice Location Address
First Line	:	1717 BOYSON RD
Second Line	:
City	:	HIAWATHA
State	:	IA
Zip	:	52233-2313
Country	:	US
Telephone Number	:	319-200-2004
Fax Number	:

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

Provider Enumeration Date	:	11/06/2019
Last Update Date	:	11/06/2019

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