MEDICARE: SCHOLAR REHAB

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	PCET001924	GA

General Provider Information

NPI Number	:	1093147662
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCHOLAR REHAB

Provider Business Mailing Address
First Line	:	128 FRANCES MEEKS WAY STE 9
Second Line	:
City	:	RICHMOND HILL
State	:	GA
Zip	:	31324-3984
Country	:	US
Telephone Number	:	912-507-3919
Fax Number	:

Provider Business Practice Location Address
First Line	:	128 FRANCES MEEKS WAY STE 9
Second Line	:
City	:	RICHMOND HILL
State	:	GA
Zip	:	31324-3984
Country	:	US
Telephone Number	:	912-507-3919
Fax Number	:

Authorized Official
Title or Position	:	OCCUPATIONAL THERAPIST
Name	:	MRS. LAUREN S SCHOLAR
Credential	:	OTR/L
Telephone Number	:	912-727-2321

Provider Enumeration Date	:	08/06/2013
Last Update Date	:	08/06/2013

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Practice Location Address:

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Directions to “SCHOLAR REHAB ” Practice Location

Language	Start Address	Practice Location

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