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NPI Code Detail

MEDICARE: ALICE WILSON PIERCE MA CCC-SLP

MEDICARE:   ALICE WILSON PIERCE  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 Pathologist682AL

General Provider Information

NPI Number : 1780613133
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALICE WILSON PIERCE MA CCC-SLP
Provider Business Mailing Address
First Line : 2416 MEADOW RIDGE RD
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35242-2990
Country : US
Telephone Number : 205-995-1979
Fax Number : 205-995-1997
Provider Business Practice Location Address
First Line : 245 CAHABA VALLEY PKWY
Second Line :
City : PELHAM
State : AL
Zip : 35124-2216
Country : US
Telephone Number : 205-942-6820
Fax Number : 205-942-5627
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2006
Last Update Date : 07/08/2007

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Directions to “ ALICE WILSON PIERCE MA CCC-SLP” Practice Location

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