MEDICARE: MRS. JUDITH ADAMS MA 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	SLP002040	GA

General Provider Information

NPI Number	:	1407186307
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JUDITH ADAMS MA CCC-SLP

Provider Business Mailing Address
First Line	:	1225 W INTERSTATE 20 APT 11108
Second Line	:
City	:	GRAND PRAIRIE
State	:	TX
Zip	:	75052-1417
Country	:	US
Telephone Number	:	682-239-9826
Fax Number	:

Provider Business Practice Location Address
First Line	:	4628 BELLADONNA DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76123-1841
Country	:	US
Telephone Number	:	682-239-9826
Fax Number	:

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

Provider Enumeration Date	:	12/28/2009
Last Update Date	:	01/21/2025

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Directions to “ MRS. JUDITH ADAMS MA CCC-SLP” Practice Location

Language	Start Address	Practice Location

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