MEDICARE: MRS. NONDI C CHAPPELL M. ED 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	SLP001763	GA

General Provider Information

NPI Number	:	1063852499
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. NONDI C CHAPPELL M. ED CCC-SLP

Provider Business Mailing Address
First Line	:	3141 BRIGHTON PASS
Second Line	:
City	:	CONYERS
State	:	GA
Zip	:	30094-3357
Country	:	US
Telephone Number	:	404-202-8490
Fax Number	:	770-679-9344

Provider Business Practice Location Address
First Line	:	2395 WALL ST SE
Second Line	:	SUITE 190
City	:	CONYERS
State	:	GA
Zip	:	30013-6703
Country	:	US
Telephone Number	:	404-202-8490
Fax Number	:	770-679-9344

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

Provider Enumeration Date	:	06/29/2013
Last Update Date	:	12/11/2013

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Directions to “ MRS. NONDI C CHAPPELL M. ED CCC-SLP” Practice Location

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