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NPI Code Detail

MEDICARE: TARA LYNN DOMBACH MS-CCC-SLP

MEDICARE: TARA LYNN DOMBACH MS-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
1235Z00000XSpeech-Language PathologistSL007436PA

General Provider Information

NPI Number : 1578730099
Entity Type Code : Individual
Provider Name (Legal Business Name) : TARA LYNN DOMBACH MS-CCC-SLP
Provider Business Mailing Address
First Line : 900 E KING ST
Second Line :
City : LANCASTER
State : PA
Zip : 17602-3272
Country : US
Telephone Number : 717-293-7279
Fax Number : 717-735-3106
Provider Business Practice Location Address
First Line : 900 E KING ST
Second Line :
City : LANCASTER
State : PA
Zip : 17602-3272
Country : US
Telephone Number : 717-293-7279
Fax Number : 717-735-3106
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/14/2008
Last Update Date : 05/14/2008

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Directions to “ TARA LYNN DOMBACH MS-CCC-SLP” Practice Location

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