MEDICARE: DREW PERO 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
1	235Z00000X	Speech-Language Pathologist	1396158-4102	UT
2	235Z00000X	Speech-Language Pathologist	SA22251	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1649977976
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DREW PERO M.A., CCC-SLP

Provider Business Mailing Address
First Line	:	2145 E PINNACLE TERRACE WAY APT 201
Second Line	:
City	:	COTTONWOOD HEIGHTS
State	:	UT
Zip	:	84121-5063
Country	:	US
Telephone Number	:	330-275-2226
Fax Number	:

Provider Business Practice Location Address
First Line	:	9119 S MONROE PLAZA WAY
Second Line	:
City	:	SANDY
State	:	UT
Zip	:	84070-2682
Country	:	US
Telephone Number	:	330-275-2226
Fax Number	:

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

Provider Enumeration Date	:	02/07/2023
Last Update Date	:	09/18/2024

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Directions to “ DREW PERO M.A., CCC-SLP” Practice Location

Language	Start Address	Practice Location

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