MEDICARE: BRIAN J SCHROEDER 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	SP-5776	OH

General Provider Information

NPI Number	:	1053566570
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN J SCHROEDER M.S. CCC-SLP

Provider Business Mailing Address
First Line	:	10133 SPRINGFIELD PIKE
Second Line	:	SUITE D
City	:	CINCINNATI
State	:	OH
Zip	:	45215-1428
Country	:	US
Telephone Number	:	513-821-0110
Fax Number	:

Provider Business Practice Location Address
First Line	:	10133 SPRINGFIELD PIKE
Second Line	:	SUITE D
City	:	CINCINNATI
State	:	OH
Zip	:	45215-1428
Country	:	US
Telephone Number	:	513-821-0110
Fax Number	:

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

Provider Enumeration Date	:	11/25/2008
Last Update Date	:	11/25/2008

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