MEDICARE: JEANNE MARIE CHIRDON 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	5475	SC

General Provider Information

NPI Number	:	1851790422
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEANNE MARIE CHIRDON SLP

Provider Business Mailing Address
First Line	:	48 SALEM AVE
Second Line	:
City	:	ASHEVILLE
State	:	NC
Zip	:	28804-3338
Country	:	US
Telephone Number	:	216-256-9628
Fax Number	:	843-884-6481

Provider Business Practice Location Address
First Line	:	3100 TRADITION CIR
Second Line	:
City	:	MOUNT PLEASANT
State	:	SC
Zip	:	29466-7200
Country	:	US
Telephone Number	:	843-654-7945
Fax Number	:	843-884-6481

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

Provider Enumeration Date	:	08/19/2014
Last Update Date	:	08/22/2014

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Directions to “ JEANNE MARIE CHIRDON SLP” Practice Location

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