MEDICARE: CATHY HALE MSC,CCC-S

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	SA956	FL

General Provider Information

NPI Number	:	1740335769
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHY HALE MSC,CCC-S

Provider Business Mailing Address
First Line	:	17521 US HIGHWAY 441
Second Line	:	SUITE 6
City	:	MOUNT DORA
State	:	FL
Zip	:	32757-6737
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	17521 US HIGHWAY 441
Second Line	:	SUITE 6
City	:	MOUNT DORA
State	:	FL
Zip	:	32757-6737
Country	:	US
Telephone Number	:	352-385-1944
Fax Number	:

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

Provider Enumeration Date	:	01/23/2007
Last Update Date	:	07/08/2007

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