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NPI Code Detail

MEDICARE: MRS. MAIR OLMSTED FREDERICK CCC-SLP

MEDICARE: MRS. MAIR OLMSTED FREDERICK 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
1235Z00000XSpeech-Language Pathologist007022-1NY

General Provider Information

NPI Number : 1629363981
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MAIR OLMSTED FREDERICK CCC-SLP
Provider Business Mailing Address
First Line : 68 N WILLOW ST
Second Line :
City : EAST AURORA
State : NY
Zip : 14052-1611
Country : US
Telephone Number : 716-655-4325
Fax Number :
Provider Business Practice Location Address
First Line : 1397 ORCHARD PARK RD
Second Line :
City : WEST SENECA
State : NY
Zip : 14224-4029
Country : US
Telephone Number : 716-677-3620
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2011
Last Update Date : 06/15/2011

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Directions to “ MRS. MAIR OLMSTED FREDERICK CCC-SLP” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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