MEDICARE: MOUNTAIN SPEECH THERAPY, PLLC

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

General Provider Information

NPI Number	:	1609044346
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOUNTAIN SPEECH THERAPY, PLLC

Provider Business Mailing Address
First Line	:	PO BOX 391
Second Line	:
City	:	MARS HILL
State	:	NC
Zip	:	28754-0391
Country	:	US
Telephone Number	:	828-649-1779
Fax Number	:	828-649-1779

Provider Business Practice Location Address
First Line	:	1511 CALIFORNIA CREEK RD
Second Line	:
City	:	MARS HILL
State	:	NC
Zip	:	28754-7530
Country	:	US
Telephone Number	:	828-649-1779
Fax Number	:	828-649-1779

Authorized Official
Title or Position	:	OWNER
Name	:	NANETTE RAMSEY
Credential	:	M.S.,CCC-SLP
Telephone Number	:	828-649-1779

Provider Enumeration Date	:	02/15/2008
Last Update Date	:	06/17/2008

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