MEDICARE: ANDREW MEADE FLYNN 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	6417	NC
2	235Z00000X	Speech-Language Pathologist	146012446	IL

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	:	1427026988
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW MEADE FLYNN M.A. CCC-SLP

Provider Business Mailing Address
First Line	:	7464 MAPLE AVE
Second Line	:
City	:	MAPLEWOOD
State	:	MO
Zip	:	63143-3030
Country	:	US
Telephone Number	:	910-619-8565
Fax Number	:	866-453-9441

Provider Business Practice Location Address
First Line	:	7464 MAPLE AVE
Second Line	:
City	:	MAPLEWOOD
State	:	MO
Zip	:	63143-3030
Country	:	US
Telephone Number	:	910-619-8565
Fax Number	:	866-453-9441

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

Provider Enumeration Date	:	03/10/2006
Last Update Date	:	11/19/2015

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Directions to “ ANDREW MEADE FLYNN M.A. CCC-SLP” Practice Location

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