MEDICARE: MS. LOUISE B. FELTON 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	1266	NC

General Provider Information

NPI Number	:	1013126523
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LOUISE B. FELTON CCC-SLP

Provider Business Mailing Address
First Line	:	2128 KAYBIRD LN
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28270-1108
Country	:	US
Telephone Number	:	704-844-8031
Fax Number	:

Provider Business Practice Location Address
First Line	:	2128 KAYBIRD LN
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28270-1108
Country	:	US
Telephone Number	:	704-844-8031
Fax Number	:

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

Provider Enumeration Date	:	05/21/2007
Last Update Date	:	09/25/2008

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Directions to “ MS. LOUISE B. FELTON CCC-SLP” Practice Location

Language	Start Address	Practice Location

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