Miranda Mae Riddle, MS., CCC-SLP
NPI 1407524168ActiveIndividual· Speech-Language Pathologist· Macomb, IL
Speech-Language Pathologist (MS., CCC-SLP) in Macomb, Illinois, licensed in IL and TX, with an NPI issued in August 2021. Enrolled in Medicare as practitioner - qualified speech language pathologist and practitioner - qualified speech language pathologist.
Overview
| NPI | 1407524168 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | MS., CCC-SLP |
| Sole proprietor | Yes |
| NPI issued | Aug 30, 2021 |
| Last updated in NPPES | Jan 12, 2023 |
| Certified by provider | Jan 12, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Speech-Language Pathologist Primary | 235Z00000X | 146.016080 | IL |
| Speech-Language Pathologist | 235Z00000X | 146016080 | IL |
| Speech-Language Pathologist | 235Z00000X | 114598 | TX |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Qualified Speech Language Pathologist (FL); Practitioner - Qualified Speech Language Pathologist (IL) |
|---|
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