MEDICARE: DAPHNE TALFORD 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

General Provider Information

NPI Number	:	1487040515
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAPHNE TALFORD CCC-SLP

Provider Business Mailing Address
First Line	:	6000 POPLAR AVE
Second Line	:	SUITE 250
City	:	MEMPHIS
State	:	TN
Zip	:	38119-3981
Country	:	US
Telephone Number	:	901-221-4010
Fax Number	:	901-221-4011

Provider Business Practice Location Address
First Line	:	6000 POPLAR AVE
Second Line	:	SUITE 250
City	:	MEMPHIS
State	:	TN
Zip	:	38119-3981
Country	:	US
Telephone Number	:	901-221-4010
Fax Number	:	901-221-4011

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

Provider Enumeration Date	:	04/15/2015
Last Update Date	:	04/15/2015

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Directions to “ DAPHNE TALFORD CCC-SLP” Practice Location

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