MEDICARE: CHARLES MORGAN BAYLOR 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	SL002638L	PA

General Provider Information

NPI Number	:	1548427438
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARLES MORGAN BAYLOR M.S.,CCC-SLP

Provider Business Mailing Address
First Line	:	316 WARREN ST
Second Line	:
City	:	WEST PITTSTON
State	:	PA
Zip	:	18643-2353
Country	:	US
Telephone Number	:	570-654-8246
Fax Number	:

Provider Business Practice Location Address
First Line	:	316 WARREN ST
Second Line	:
City	:	WEST PITTSTON
State	:	PA
Zip	:	18643-2353
Country	:	US
Telephone Number	:	570-654-8246
Fax Number	:

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

Provider Enumeration Date	:	05/19/2008
Last Update Date	:	05/19/2008

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Directions to “ CHARLES MORGAN BAYLOR M.S.,CCC-SLP” Practice Location

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