MEDICARE: MRS. MARY JANE CURTIN 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	2042	AL

General Provider Information

NPI Number	:	1578606679
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARY JANE CURTIN MS,CCC-SLP

Provider Business Mailing Address
First Line	:	6260 DORSETT WOODS DR
Second Line	:
City	:	MOUNT OLIVE
State	:	AL
Zip	:	35117-3644
Country	:	US
Telephone Number	:	256-739-1430
Fax Number	:	256-775-0310

Provider Business Practice Location Address
First Line	:	6260 DORSETT WOODS DR
Second Line	:
City	:	MOUNT OLIVE
State	:	AL
Zip	:	35117-3644
Country	:	US
Telephone Number	:	256-739-1430
Fax Number	:	256-755-0310

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

Provider Enumeration Date	:	02/15/2007
Last Update Date	:	07/08/2007

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