MEDICARE: MR. DONALD MCCLAREN OWENS JR. 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	2808	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184673915
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DONALD MCCLAREN OWENS JR. CCC/SLP

Provider Business Mailing Address
First Line	:	10908 CHESTNUT HILL DR
Second Line	:
City	:	MATTHEWS
State	:	NC
Zip	:	28105-7602
Country	:	US
Telephone Number	:	704-846-2198
Fax Number	:

Provider Business Practice Location Address
First Line	:	10908 CHESTNUT HILL DR
Second Line	:
City	:	MATTHEWS
State	:	NC
Zip	:	28105-7602
Country	:	US
Telephone Number	:	704-846-2198
Fax Number	:

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

Provider Enumeration Date	:	05/09/2006
Last Update Date	:	07/09/2007

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Directions to “ MR. DONALD MCCLAREN OWENS JR. CCC/SLP” Practice Location

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