MEDICARE: KARA LYNN MAHARAY M.S.

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	SL008044	PA

General Provider Information

NPI Number	:	1285927632
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARA LYNN MAHARAY M.S.

Provider Business Mailing Address
First Line	:	112 W UPSAL ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19119-3206
Country	:	US
Telephone Number	:	610-529-7569
Fax Number	:

Provider Business Practice Location Address
First Line	:	112 W UPSAL ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19119-3206
Country	:	US
Telephone Number	:	610-529-7569
Fax Number	:

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

Provider Enumeration Date	:	05/18/2011
Last Update Date	:	05/18/2011

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