MEDICARE: SPEECH THERAPY SOLUTIONS, LLC

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	224Z00000X	Occupational Therapy Assistant
2	225X00000X	Occupational Therapist
3	225100000X	Physical Therapist
4	225A00000X	Music Therapist
5	225XF0002X	Feeding, Eating & Swallowing Occupational Therapist
6	231H00000X	Audiologist
7	231HA2400X	Assistive Technology Practitioner Audiologist
8	2355S0801X	Speech-Language Assistant	SLPA 8363	AZ
9	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1275924219
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPEECH THERAPY SOLUTIONS, LLC

Provider Business Mailing Address
First Line	:	3012 N 17TH AVE
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85015-6112
Country	:	US
Telephone Number	:	480-788-8353
Fax Number	:

Provider Business Practice Location Address
First Line	:	3012 N 17TH AVE
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85015-6112
Country	:	US
Telephone Number	:	480-788-8353
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. LAURA FULLER
Credential	:	SLPA
Telephone Number	:	480-788-8353

Provider Enumeration Date	:	02/12/2015
Last Update Date	:	02/12/2015

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