MEDICARE: CHARLA ALBRIGHT 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-1256	NV

General Provider Information

NPI Number	:	1063739522
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARLA ALBRIGHT SLP

Provider Business Mailing Address
First Line	:	3427 GONI RD
Second Line	:	#104
City	:	CARSON CITY
State	:	NV
Zip	:	89706-8011
Country	:	US
Telephone Number	:	775-687-0101
Fax Number	:

Provider Business Practice Location Address
First Line	:	3427 GONI RD
Second Line	:	#104
City	:	CARSON CITY
State	:	NV
Zip	:	89706-8011
Country	:	US
Telephone Number	:	775-687-0101
Fax Number	:	775-687-0110

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

Provider Enumeration Date	:	04/23/2010
Last Update Date	:	12/10/2013

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Directions to “ CHARLA ALBRIGHT SLP” Practice Location

Language	Start Address	Practice Location

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