MEDICARE: AAC ASSOCIATES SPEECH & LANGUAGE SPECIALTIES 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	225X00000X	Occupational Therapist
2	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1346995529
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AAC ASSOCIATES SPEECH & LANGUAGE SPECIALTIES LLC

Provider Business Mailing Address
First Line	:	217 ALEXANDER DARIUS CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89106-4364
Country	:	US
Telephone Number	:	803-413-3947
Fax Number	:

Provider Business Practice Location Address
First Line	:	217 ALEXANDER DARIUS CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89106-4364
Country	:	US
Telephone Number	:	803-413-3947
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	FAATIMAH MALIKA PATTERSON
Credential	:	M.S. CCC-SLP
Telephone Number	:	803-413-3947

Provider Enumeration Date	:	02/16/2022
Last Update Date	:	02/16/2022

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