MEDICARE: MRS. ALICIA MARIE PALMER M.A., 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	SA6838	FL
2	222Q00000X	Developmental Therapist

Other Identifiers

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

General Provider Information

NPI Number	:	1376561670
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ALICIA MARIE PALMER M.A., CCC-SLP

Provider Business Mailing Address
First Line	:	129 E EVANS ST
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32804-3912
Country	:	US
Telephone Number	:	321-663-0937
Fax Number	:

Provider Business Practice Location Address
First Line	:	4401 E COLONIAL DR
Second Line	:	SUITE 107
City	:	ORLANDO
State	:	FL
Zip	:	32803-5200
Country	:	US
Telephone Number	:	407-898-5060
Fax Number	:	407-898-5185

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

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	01/19/2010

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Directions to “ MRS. ALICIA MARIE PALMER M.A., CCC-SLP” Practice Location

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