MEDICARE: ECHO THERAPY, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	225X00000X	Occupational Therapist
2	225100000X	Physical Therapist
3	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1548842537
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ECHO THERAPY, LLC

Provider Business Mailing Address
First Line	:	2345 SPRUCE GOOSE ST APT C327
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89135-2625
Country	:	US
Telephone Number	:	724-272-1759
Fax Number	:

Provider Business Practice Location Address
First Line	:	2345 SPRUCE GOOSE ST APT C327
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89135-2625
Country	:	US
Telephone Number	:	724-272-1759
Fax Number	:

Authorized Official
Title or Position	:	OWNER/SPEECH LANGUAGE PATHOLOGIST
Name	:	EMILY SWOGGER
Credential	:	M.S., SLP-CCC/L
Telephone Number	:	724-272-1759

Provider Enumeration Date	:	04/28/2021
Last Update Date	:	04/28/2021

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Directions to “ECHO THERAPY, LLC ” Practice Location

Language	Start Address	Practice Location

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