MEDICARE: TRINETTA MCCLAM 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		MD

General Provider Information

NPI Number	:	1821426784
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRINETTA MCCLAM M.S. CCC-SLP

Provider Business Mailing Address
First Line	:	3820 POPE ST SE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20020-2358
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1200 1ST ST NE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20002-3361
Country	:	US
Telephone Number	:	202-442-5885
Fax Number	:

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

Provider Enumeration Date	:	10/30/2013
Last Update Date	:	10/30/2013

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Directions to “ TRINETTA MCCLAM M.S. CCC-SLP” Practice Location

Language	Start Address	Practice Location

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