MEDICARE: MADELYNE TORRES 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	3216	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	83788	OTHER	NC	BCBS

General Provider Information

NPI Number	:	1760513691
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MADELYNE TORRES SLP

Provider Business Mailing Address
First Line	:	128 SALEM TOWNE CT
Second Line	:
City	:	APEX
State	:	NC
Zip	:	27502-2311
Country	:	US
Telephone Number	:	919-367-9830
Fax Number	:	919-367-9831

Provider Business Practice Location Address
First Line	:	128 SALEM TOWNE CT
Second Line	:
City	:	APEX
State	:	NC
Zip	:	27502-2311
Country	:	US
Telephone Number	:	919-367-9830
Fax Number	:	919-367-9831

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

Provider Enumeration Date	:	03/09/2007
Last Update Date	:	07/08/2007

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