MEDICARE: MS. MAREN L BUSH M.S.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
1	235Z00000X	Speech-Language Pathologist	014018-1	NY

General Provider Information

NPI Number	:	1821163783
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MAREN L BUSH M.S.CCC-SLP

Provider Business Mailing Address
First Line	:	535 MAIN ST
Second Line	:
City	:	OLEAN
State	:	NY
Zip	:	14760-1500
Country	:	US
Telephone Number	:	716-376-2216
Fax Number	:

Provider Business Practice Location Address
First Line	:	535 MAIN ST
Second Line	:
City	:	OLEAN
State	:	NY
Zip	:	14760-1500
Country	:	US
Telephone Number	:	716-376-2216
Fax Number	:

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

Provider Enumeration Date	:	11/22/2006
Last Update Date	:	02/26/2010

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Directions to “ MS. MAREN L BUSH M.S.CCC-SLP” Practice Location

Language	Start Address	Practice Location

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