MEDICARE: MS. PAMELA ANN LACHOWSKY MSE CCCSLP

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	SA3510	FL
2	235Z00000X	Speech-Language Pathologist	2426	AL
3	235Z00000X	Speech-Language Pathologist	SLP005110	GA

General Provider Information

NPI Number	:	1114902012
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. PAMELA ANN LACHOWSKY MSE CCCSLP

Provider Business Mailing Address
First Line	:	151 GOLDEN OAKS RD
Second Line	:
City	:	ZOLFO SPRINGS
State	:	FL
Zip	:	33890-4757
Country	:	US
Telephone Number	:	863-245-9336
Fax Number	:	863-735-8274

Provider Business Practice Location Address
First Line	:	151 GOLDEN OAKS RD
Second Line	:
City	:	ZOLFO SPRINGS
State	:	FL
Zip	:	33890-4757
Country	:	US
Telephone Number	:	863-245-9336
Fax Number	:	863-735-8274

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

Provider Enumeration Date	:	12/13/2005
Last Update Date	:	07/08/2007

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