MEDICARE: JOAN ANN KRUEGER 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	SA1827	FL

General Provider Information

NPI Number	:	1093965519
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOAN ANN KRUEGER SLP

Provider Business Mailing Address
First Line	:	4015 W PALM AIRE DR APT 807
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33069-4177
Country	:	US
Telephone Number	:	954-972-5060
Fax Number	:

Provider Business Practice Location Address
First Line	:	4015 W PALM AIRE DR APT 807
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33069-4177
Country	:	US
Telephone Number	:	954-972-5060
Fax Number	:

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

Provider Enumeration Date	:	09/19/2008
Last Update Date	:	09/19/2008

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Directions to “ JOAN ANN KRUEGER SLP” Practice Location

Language	Start Address	Practice Location

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