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NPI Code Detail

MEDICARE: NORMA JEAN SLUDER M.A.CCC/SLP

MEDICARE: NORMA JEAN SLUDER M.A.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 Pathologist0000002466TN

General Provider Information

NPI Number : 1558720003
Entity Type Code : Individual
Provider Name (Legal Business Name) : NORMA JEAN SLUDER M.A.CCC/SLP
Provider Business Mailing Address
First Line : 100 HOMESTEAD ST NE
Second Line :
City : CLEVELAND
State : TN
Zip : 37323-5462
Country : US
Telephone Number : 423-715-2732
Fax Number :
Provider Business Practice Location Address
First Line : 537 SPRING ST
Second Line :
City : DOVER
State : TN
Zip : 37058-3232
Country : US
Telephone Number : 931-232-6902
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/12/2016
Last Update Date : 02/12/2016

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Directions to “ NORMA JEAN SLUDER M.A.CCC/SLP” Practice Location

Language Start Address Practice Location
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