MEDICARE: A TO Z SPEECH THERAPY PLLC

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	7294	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871854240
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A TO Z SPEECH THERAPY PLLC

Provider Business Mailing Address
First Line	:	212 W MOSS CREEK DR
Second Line	:
City	:	CLAYTON
State	:	NC
Zip	:	27520-6912
Country	:	US
Telephone Number	:	919-389-8907
Fax Number	:

Provider Business Practice Location Address
First Line	:	212 W MOSS CREEK DR
Second Line	:
City	:	CLAYTON
State	:	NC
Zip	:	27520-6912
Country	:	US
Telephone Number	:	919-389-8907
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/SPEECH LANGUAGE PATHOLOGI
Name	:	ALIYA BOONE
Credential	:	CCC-SLP
Telephone Number	:	919-389-8907

Provider Enumeration Date	:	06/01/2012
Last Update Date	:	06/01/2012

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Directions to “A TO Z SPEECH THERAPY PLLC ” Practice Location

Language	Start Address	Practice Location

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