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Organization

ROSEMARY AYRES, MS, CCC-SLP

Active
Other names
Speech Camp
Organization subpart
No

Provider details

NPI number
Authorized official
MS. ROSEMARY S AYRES MS, CCC-SLP (SPEECH PATHOLOGIST, OWNER)
(541) 929-4568
Entity
Organization

Contact information

Practice address
138 S 12TH STR, PHILOMATH, OR 97370-1492
(541) 929-4568
(541) 929-4513
Mailing address
PO BOX 1492, PHILOMATH, OR 97370-1492
(541) 929-4568
(541) 929-4513

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
10192
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
138396
OMAP-OFFICE MEDICAL ASSIS
OR
01
14951000
REGENT BLUE CROSS BLUE SH
OR
01
Y6967-01
PACIFICSOURCE HEALTHCARE
OR
Enumeration date
02/23/2007
Last updated
06/17/2008
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