MEDICARE: MS. ANN LUNA 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	SP-2790	OH

General Provider Information

NPI Number	:	1518176213
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANN LUNA CCC-SLP

Provider Business Mailing Address
First Line	:	435 GREEN ACRE CIR
Second Line	:
City	:	HOWARD
State	:	OH
Zip	:	43028-9524
Country	:	US
Telephone Number	:	740-397-2854
Fax Number	:

Provider Business Practice Location Address
First Line	:	435 GREEN ACRE CIR
Second Line	:
City	:	HOWARD
State	:	OH
Zip	:	43028-9524
Country	:	US
Telephone Number	:	740-397-2854
Fax Number	:

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

Provider Enumeration Date	:	05/21/2007
Last Update Date	:	07/08/2007

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Directions to “ MS. ANN LUNA CCC-SLP” Practice Location

Language	Start Address	Practice Location

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