MEDICARE: ALLIE RAELENE GIERMAN 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
1	235Z00000X	Speech-Language Pathologist	7152000589	MI

General Provider Information

NPI Number	:	1578255758
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLIE RAELENE GIERMAN MA, CCC/SLP

Provider Business Mailing Address
First Line	:	701 SNOW RD STE A
Second Line	:
City	:	LANSING
State	:	MI
Zip	:	48917-4087
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	701 SNOW RD STE A
Second Line	:
City	:	LANSING
State	:	MI
Zip	:	48917-4087
Country	:	US
Telephone Number	:	517-323-0593
Fax Number	:	517-333-8539

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

Provider Enumeration Date	:	05/24/2023
Last Update Date	:	10/15/2024

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