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NPI Code Detail

MEDICARE: CAROL HART BOEKE MS, CCC-SLP

MEDICARE: CAROL HART BOEKE MS, 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
1235Z00000XSpeech-Language Pathologist01297IA

General Provider Information

NPI Number : 1124248695
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROL HART BOEKE MS, CCC-SLP
Provider Business Mailing Address
First Line : 311 SCHUBERT CIR
Second Line :
City : AMES
State : IA
Zip : 50014-7720
Country : US
Telephone Number : 515-232-7220
Fax Number :
Provider Business Practice Location Address
First Line : 1915 PHILADELPHIA ST
Second Line :
City : AMES
State : IA
Zip : 50010-8768
Country : US
Telephone Number : 515-232-7220
Fax Number : 515-232-3834
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/26/2007
Last Update Date : 07/08/2007

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Directions to “ CAROL HART BOEKE MS, CCC-SLP” Practice Location

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