MEDICARE: WELLS COMMUNICATION AND FEEDING THERAPY, 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	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1790459741
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WELLS COMMUNICATION AND FEEDING THERAPY, LLC

Provider Business Mailing Address
First Line	:	10996 HUNTING HAWK RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89179-2072
Country	:	US
Telephone Number	:	702-767-2122
Fax Number	:

Provider Business Practice Location Address
First Line	:	10996 HUNTING HAWK RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89179-2072
Country	:	US
Telephone Number	:	702-767-2122
Fax Number	:	702-745-0585

Authorized Official
Title or Position	:	OWNER
Name	:	JOCELYN WELLS
Credential	:
Telephone Number	:	702-767-2122

Provider Enumeration Date	:	08/03/2021
Last Update Date	:	03/09/2022

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Directions to “WELLS COMMUNICATION AND FEEDING THERAPY, LLC ” Practice Location

Language	Start Address	Practice Location

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