MEDICARE: CHARLOTTE ELIZABETH NEFF 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
1	235Z00000X	Speech-Language Pathologist	22006763A	IN

General Provider Information

NPI Number	:	1134684764
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARLOTTE ELIZABETH NEFF CCC-SLP

Provider Business Mailing Address
First Line	:	21222 TERRACE TRL
Second Line	:
City	:	NEW PARIS
State	:	IN
Zip	:	46553-9677
Country	:	US
Telephone Number	:	574-202-4317
Fax Number	:

Provider Business Practice Location Address
First Line	:	902 PROVIDENT DR STE C
Second Line	:
City	:	WARSAW
State	:	IN
Zip	:	46580-3379
Country	:	US
Telephone Number	:	574-376-2316
Fax Number	:

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

Provider Enumeration Date	:	02/07/2019
Last Update Date	:	11/04/2020

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