MEDICARE: MRS. ELLEN B. RIKARD MCD, 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	4884	SC

General Provider Information

NPI Number	:	1326388935
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ELLEN B. RIKARD MCD, CCC-SLP

Provider Business Mailing Address
First Line	:	338 W COLUMBIA AVE
Second Line	:
City	:	BATESBURG
State	:	SC
Zip	:	29006-2028
Country	:	US
Telephone Number	:	803-532-4452
Fax Number	:	803-532-4453

Provider Business Practice Location Address
First Line	:	338 W COLUMBIA AVE
Second Line	:
City	:	BATESBURG
State	:	SC
Zip	:	29006-2028
Country	:	US
Telephone Number	:	803-532-4452
Fax Number	:	803-532-4453

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

Provider Enumeration Date	:	02/19/2013
Last Update Date	:	02/19/2013

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Directions to “ MRS. ELLEN B. RIKARD MCD, CCC-SLP” Practice Location

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