MEDICARE: MRS. MIA STANLEY MEHAFFEY 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	9929	NC

General Provider Information

NPI Number	:	1922488162
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MIA STANLEY MEHAFFEY M.S., CCC-SLP

Provider Business Mailing Address
First Line	:	54 ALPINE WAY
Second Line	:
City	:	CLYDE
State	:	NC
Zip	:	28721-5400
Country	:	US
Telephone Number	:	828-421-1472
Fax Number	:	828-631-1623

Provider Business Practice Location Address
First Line	:	380 BREVARD RD
Second Line	:
City	:	ASHEVILLE
State	:	NC
Zip	:	28806-2945
Country	:	US
Telephone Number	:	828-253-4437
Fax Number	:	828-255-8635

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

Provider Enumeration Date	:	06/03/2015
Last Update Date	:	06/03/2015

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Directions to “ MRS. MIA STANLEY MEHAFFEY M.S., CCC-SLP” Practice Location

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