MEDICARE: EMILY MCCABE 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	2008032501	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2008032501	OTHER	MO	SLP LICENSE
3	SZ 4214	OTHER	FL	MEDICAL LICENCE

General Provider Information

NPI Number	:	1548454762
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY MCCABE CCC/SLP

Provider Business Mailing Address
First Line	:	8540 SCARBOROUGH DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-7502
Country	:	US
Telephone Number	:	719-597-0822
Fax Number	:

Provider Business Practice Location Address
First Line	:	8540 SCARBOROUGH DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-7502
Country	:	US
Telephone Number	:	719-597-0822
Fax Number	:

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

Provider Enumeration Date	:	08/30/2007
Last Update Date	:	11/24/2010

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Directions to “ EMILY MCCABE CCC/SLP” Practice Location

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