MEDICARE: GERALDINE MILAGROJA TOWLES MED 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	0000001550	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	SP0000001550	OTHER	TN	STATE LICENSE

General Provider Information

NPI Number	:	1235227414
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GERALDINE MILAGROJA TOWLES MED CCCSLP

Provider Business Mailing Address
First Line	:	6109 ALLEN COURT
Second Line	:
City	:	HERMITAGE
State	:	TN
Zip	:	37076
Country	:	US
Telephone Number	:	615-391-0449
Fax Number	:

Provider Business Practice Location Address
First Line	:	4901 NOLENSVILLE PIKE
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37211-5411
Country	:	US
Telephone Number	:	615-988-2340
Fax Number	:	615-988-2643

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

Provider Enumeration Date	:	10/11/2006
Last Update Date	:	01/09/2020

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Directions to “ GERALDINE MILAGROJA TOWLES MED CCCSLP” Practice Location

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