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NPI Code Detail

MEDICARE: MS. MAUREEN TYRRELL MA,CCC,SLP

MEDICARE: MS. MAUREEN TYRRELL 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
1235Z00000XSpeech-Language PathologistSP-7605OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1314380051027OTHEROHCARESOURCE INS. CO.
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1548229198
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MAUREEN TYRRELL MA,CCC,SLP
Provider Business Mailing Address
First Line : 3500 ABBOTTS MILL DR
Second Line :
City : WILLOUGHBY
State : OH
Zip : 44094-6473
Country : US
Telephone Number : 216-280-0309
Fax Number :
Provider Business Practice Location Address
First Line : 1929A E ROYALTON RD
Second Line :
City : BROADVIEW HTS
State : OH
Zip : 44147-2809
Country : US
Telephone Number : 440-838-0990
Fax Number : 440-838-8440
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2006
Last Update Date : 09/23/2010

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