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NPI Code Detail

MEDICARE: MRS. TERRY LYNN MCWILLIAMS MA/CCC-SLP

MEDICARE:  MRS. TERRY LYNN MCWILLIAMS  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
1235Z00000XSpeech-Language Pathologist603-154WI

General Provider Information

NPI Number : 1740231612
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TERRY LYNN MCWILLIAMS MA/CCC-SLP
Provider Business Mailing Address
First Line : 240 W FOX DALE RD
Second Line :
City : GLENDALE
State : WI
Zip : 53217-3916
Country : US
Telephone Number : 262-242-6221
Fax Number : 414-351-8846
Provider Business Practice Location Address
First Line : 6700 N PORT WASHINGTON RD
Second Line :
City : GLENDALE
State : WI
Zip : 53217-3919
Country : US
Telephone Number : 414-351-8850
Fax Number : 414-351-8846
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2006
Last Update Date : 07/08/2007

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Directions to “ MRS. TERRY LYNN MCWILLIAMS MA/CCC-SLP” Practice Location

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