MEDICARE: MRS. SUSAN E. OCAIN 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	0733	AZ

General Provider Information

NPI Number	:	1679793004
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SUSAN E. OCAIN CCC-SLP

Provider Business Mailing Address
First Line	:	6791 E ROCK CANYON PL
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85750-6071
Country	:	US
Telephone Number	:	520-991-8697
Fax Number	:

Provider Business Practice Location Address
First Line	:	6791 E ROCK CANYON PL
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85750-6071
Country	:	US
Telephone Number	:	520-991-8697
Fax Number	:

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

Provider Enumeration Date	:	04/26/2007
Last Update Date	:	07/08/2007

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