MEDICARE: MRS. LUCINDA LEE DIGGS M.S., 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	SA6543	FL

General Provider Information

NPI Number	:	1366721193
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LUCINDA LEE DIGGS M.S., CCC-SLP

Provider Business Mailing Address
First Line	:	2804 DEL PRADO BLVD S
Second Line	:	SUITE 202-3
City	:	CAPE CORAL
State	:	FL
Zip	:	33904-7252
Country	:	US
Telephone Number	:	239-540-1179
Fax Number	:	239-540-8563

Provider Business Practice Location Address
First Line	:	2804 DEL PRADO BLVD S
Second Line	:	SUITE 202-3
City	:	CAPE CORAL
State	:	FL
Zip	:	33904-7252
Country	:	US
Telephone Number	:	239-540-1179
Fax Number	:	239-540-8563

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

Provider Enumeration Date	:	08/10/2011
Last Update Date	:	08/10/2011

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Directions to “ MRS. LUCINDA LEE DIGGS M.S., CCC-SLP” Practice Location

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