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NPI Code Detail

MEDICARE: MS. LEE R AARON CCC.SLP

MEDICARE: MS. LEE R AARON 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
1171W00000XContractorSL001002LPA
2235Z00000XSpeech-Language PathologistSL001002LPA

Other Identifiers

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

General Provider Information

NPI Number : 1336311984
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LEE R AARON CCC.SLP
Provider Business Mailing Address
First Line : 7051 PASSYUNK AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19142-1724
Country : US
Telephone Number : 215-492-1079
Fax Number : 215-492-1083
Provider Business Practice Location Address
First Line : 7051 PASSYUNK AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19142-1724
Country : US
Telephone Number : 215-492-1079
Fax Number : 215-492-1083
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2008
Last Update Date : 07/11/2012

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