MEDICARE: MRS. CLARA ANN LUNA M.A./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	117256	MO

General Provider Information

NPI Number	:	1336546712
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CLARA ANN LUNA M.A./SLP

Provider Business Mailing Address
First Line	:	85 SAINT MADELEINE CT
Second Line	:
City	:	O FALLON
State	:	MO
Zip	:	63368-7576
Country	:	US
Telephone Number	:	636-675-6991
Fax Number	:

Provider Business Practice Location Address
First Line	:	85 SAINT MADELEINE CT
Second Line	:
City	:	O FALLON
State	:	MO
Zip	:	63368-7576
Country	:	US
Telephone Number	:	636-675-6991
Fax Number	:

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

Provider Enumeration Date	:	12/01/2014
Last Update Date	:	12/01/2014

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Directions to “ MRS. CLARA ANN LUNA M.A./SLP” Practice Location

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