MEDICARE: MARYKATE HELLUMS M.S., 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	105809	TX

General Provider Information

NPI Number	:	1629580493
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARYKATE HELLUMS M.S., CCC-SLP

Provider Business Mailing Address
First Line	:	7403 MEMPHIS AVE
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79118-1132
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1601 S CLEVELAND ST
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79102-4211
Country	:	US
Telephone Number	:	806-677-5287
Fax Number	:

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

Provider Enumeration Date	:	11/01/2017
Last Update Date	:	11/01/2017

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Directions to “ MARYKATE HELLUMS M.S., CCC-SLP” Practice Location

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