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NPI Code Detail

MEDICARE: RONICA MUTH SLP

MEDICARE: RONICA MUTH 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
1235Z00000XSpeech-Language PathologistSLP-2326WV

General Provider Information

NPI Number : 1487341061
Entity Type Code : Individual
Provider Name (Legal Business Name) : RONICA MUTH SLP
Provider Business Mailing Address
First Line : 55 MORNING DOVE LN
Second Line :
City : ONA
State : WV
Zip : 25545-9627
Country : US
Telephone Number : 304-953-4999
Fax Number :
Provider Business Practice Location Address
First Line : 1390 N POPLAR FORK RD
Second Line :
City : HURRICANE
State : WV
Zip : 25526-7112
Country : US
Telephone Number : 304-757-7826
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/24/2023
Last Update Date : 04/24/2023

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