MEDICARE: CATHY ANDRIACCHI 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 280	NV

General Provider Information

NPI Number	:	1104017581
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHY ANDRIACCHI SLP

Provider Business Mailing Address
First Line	:	5451 PROGRESSO ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89135-3271
Country	:	US
Telephone Number	:	702-355-0784
Fax Number	:	792-233-1205

Provider Business Practice Location Address
First Line	:	5451 PROGRESSO ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89135-3271
Country	:	US
Telephone Number	:	702-355-0784
Fax Number	:	792-233-1205

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

Provider Enumeration Date	:	08/09/2007
Last Update Date	:	08/09/2007

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Directions to “ CATHY ANDRIACCHI SLP” Practice Location

Language	Start Address	Practice Location

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