MEDICARE: MRS. ANDREA J SWEPSON MS 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	7489	NC

General Provider Information

NPI Number	:	1932366804
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANDREA J SWEPSON MS CCC-SLP

Provider Business Mailing Address
First Line	:	17 N 31ST ST
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28405-3109
Country	:	US
Telephone Number	:	910-763-5462
Fax Number	:

Provider Business Practice Location Address
First Line	:	17 N 31ST ST
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28405-3109
Country	:	US
Telephone Number	:	910-599-7812
Fax Number	:

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

Provider Enumeration Date	:	05/19/2008
Last Update Date	:	06/01/2010

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