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NPI Code Detail

MEDICARE: PAULINE WILLS M.A., CCC-SLP

MEDICARE: PAULINE WILLS M.A., 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 PathologistC-5325NM

General Provider Information

NPI Number : 1952795718
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAULINE WILLS M.A., CCC-SLP
Provider Business Mailing Address
First Line : 1212 PAIUTE TRL
Second Line :
City : ALAMOGORDO
State : NM
Zip : 88310-4061
Country : US
Telephone Number : 575-430-9124
Fax Number :
Provider Business Practice Location Address
First Line : 10051 FOXES WAY
Second Line :
City : KING GEORGE
State : VA
Zip : 22485-3458
Country : US
Telephone Number : 540-775-4000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/19/2015
Last Update Date : 03/19/2015

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Directions to “ PAULINE WILLS M.A., CCC-SLP” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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