MEDICARE: ABEL LETTIERE M.S., 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

General Provider Information

NPI Number	:	1902097470
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABEL LETTIERE M.S., CCC-SLP

Provider Business Mailing Address
First Line	:	5351 W CHISUM TRL
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85083-6357
Country	:	US
Telephone Number	:	812-201-0076
Fax Number	:

Provider Business Practice Location Address
First Line	:	5351 W CHISUM TRL
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85083-6357
Country	:	US
Telephone Number	:	812-201-0076
Fax Number	:

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

Provider Enumeration Date	:	08/08/2007
Last Update Date	:	04/30/2015

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