MEDICARE: MRS. BRANDY FRALEY M.A./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	SP.10039	OH

General Provider Information

NPI Number	:	1952768517
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BRANDY FRALEY M.A./CCC-SLP

Provider Business Mailing Address
First Line	:	2050 STONERIDGE DR
Second Line	:
City	:	CIRCLEVILLE
State	:	OH
Zip	:	43113-8954
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	20 W SCIOTO ST
Second Line	:
City	:	COMMERCIAL POINT
State	:	OH
Zip	:	43116-9712
Country	:	US
Telephone Number	:	740-983-5000
Fax Number	:

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

Provider Enumeration Date	:	01/26/2016
Last Update Date	:	01/26/2016

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Directions to “ MRS. BRANDY FRALEY M.A./CCC-SLP” Practice Location

Language	Start Address	Practice Location

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