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NPI Code Detail

MEDICARE: MADELINE GRACE CLINE MS. CCC SLP

MEDICARE: MADELINE GRACE CLINE MS. 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 Pathologist4534AL

General Provider Information

NPI Number : 1609435577
Entity Type Code : Individual
Provider Name (Legal Business Name) : MADELINE GRACE CLINE MS. CCC SLP
Provider Business Mailing Address
First Line : 3803 RAINBOW DR
Second Line :
City : RAINBOW CITY
State : AL
Zip : 35906-3025
Country : US
Telephone Number : 256-459-5051
Fax Number :
Provider Business Practice Location Address
First Line : 3803 RAINBOW DR
Second Line :
City : RAINBOW CITY
State : AL
Zip : 35906-3025
Country : US
Telephone Number : 256-459-5051
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2019
Last Update Date : 04/14/2020

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