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NPI Code Detail

MEDICARE: MRS. NGOCANH THUY DANG MA, CCC-SLP

MEDICARE:  MRS. NGOCANH THUY DANG  MA, 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 Pathologist4499NC

General Provider Information

NPI Number : 1902055155
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. NGOCANH THUY DANG MA, CCC-SLP
Provider Business Mailing Address
First Line : 6332 CEDAR WATERS DR
Second Line :
City : RALEIGH
State : NC
Zip : 27607-5179
Country : US
Telephone Number : 919-854-0461
Fax Number :
Provider Business Practice Location Address
First Line : 6332 CEDAR WATERS DR
Second Line :
City : RALEIGH
State : NC
Zip : 27607-5179
Country : US
Telephone Number : 919-854-0461
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/11/2008
Last Update Date : 09/11/2008

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Directions to “ MRS. NGOCANH THUY DANG MA, CCC-SLP” Practice Location

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