MEDICARE: A TO Z THERAPY SERVICES, LLC

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	252Y00000X	Early Intervention Provider Agency

General Provider Information

NPI Number	:	1760620272
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A TO Z THERAPY SERVICES, LLC

Provider Business Mailing Address
First Line	:	PO BOX 8172
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63156-8172
Country	:	US
Telephone Number	:	314-749-3826
Fax Number	:

Provider Business Practice Location Address
First Line	:	5841 JULIAN AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63112-2503
Country	:	US
Telephone Number	:	314-749-3826
Fax Number	:

Authorized Official
Title or Position	:	PROFESSIONAL DIRECTOR
Name	:	RASHEEDAH FURQAN
Credential	:	MA, CCC-SLP/L
Telephone Number	:	314-749-3826

Provider Enumeration Date	:	01/22/2009
Last Update Date	:	01/22/2009

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