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NPI Code Detail

MEDICARE: MRS. AGAR MCNULTY MS CCC-SLP

MEDICARE: MRS. AGAR MCNULTY MS 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 PathologistSA 7419FL

General Provider Information

NPI Number : 1548344302
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. AGAR MCNULTY MS CCC-SLP
Provider Business Mailing Address
First Line : 9508 GRIFFIN RD
Second Line :
City : COOPER CITY
State : FL
Zip : 33328-3416
Country : US
Telephone Number : 954-689-0730
Fax Number : 888-725-9013
Provider Business Practice Location Address
First Line : 9508 GRIFFIN RD
Second Line :
City : COOPER CITY
State : FL
Zip : 33328-3416
Country : US
Telephone Number : 954-689-0730
Fax Number : 888-725-9013
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2006
Last Update Date : 03/28/2016

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