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NPI Code Detail

MEDICARE: MRS. AMY LYNN ELDER CCC-SLP

MEDICARE:  MRS. AMY LYNN ELDER  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 PathologistNC

General Provider Information

NPI Number : 1780876235
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. AMY LYNN ELDER CCC-SLP
Provider Business Mailing Address
First Line : 4012 PARK RD STE 200
Second Line :
City : CHARLOTTE
State : NC
Zip : 28209-2378
Country : US
Telephone Number : 704-332-4834
Fax Number : 704-372-9653
Provider Business Practice Location Address
First Line : 4012 PARK RD STE 200
Second Line :
City : CHARLOTTE
State : NC
Zip : 28209-2378
Country : US
Telephone Number : 704-332-4834
Fax Number : 704-372-9653
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/17/2007
Last Update Date : 06/16/2015

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Directions to “ MRS. AMY LYNN ELDER CCC-SLP” Practice Location

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