MEDICARE: ASIA FERRELL

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	08797	MD

General Provider Information

NPI Number	:	1508384827
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASIA FERRELL

Provider Business Mailing Address
First Line	:	2599 OAK ST
Second Line	:
City	:	EAST POINT
State	:	GA
Zip	:	30344-3026
Country	:	US
Telephone Number	:	404-576-8145
Fax Number	:	678-515-4149

Provider Business Practice Location Address
First Line	:	2599 OAK ST
Second Line	:
City	:	EAST POINT
State	:	GA
Zip	:	30344-3026
Country	:	US
Telephone Number	:	404-576-8145
Fax Number	:	678-515-4149

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

Provider Enumeration Date	:	09/07/2017
Last Update Date	:	12/20/2024

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Directions to “ ASIA FERRELL ” Practice Location

Language	Start Address	Practice Location

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