MEDICARE: MAURO SPEECH SERVICES, LLC

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	261QH0700X	Hearing and Speech Clinic/Center

General Provider Information

NPI Number	:	1487351193
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAURO SPEECH SERVICES, LLC

Provider Business Mailing Address
First Line	:	28430 RIDGEBROOK RD
Second Line	:
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48334-3465
Country	:	US
Telephone Number	:	313-300-8001
Fax Number	:

Provider Business Practice Location Address
First Line	:	28430 RIDGEBROOK RD
Second Line	:
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48334-3465
Country	:	US
Telephone Number	:	313-300-8001
Fax Number	:

Authorized Official
Title or Position	:	SPEECH LANGUAGE PATHOLOGIST
Name	:	MARY ELIZABETH MAURO
Credential	:	MA, CCC-SLP
Telephone Number	:	313-300-8001

Provider Enumeration Date	:	02/13/2023
Last Update Date	:	02/13/2023

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