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NPI Code Detail

MEDICARE: MRS. ELIZABETH ANN BERG SLP

MEDICARE: MRS. ELIZABETH ANN BERG 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 PathologistSL008088PA

General Provider Information

NPI Number : 1639384944
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ELIZABETH ANN BERG SLP
Provider Business Mailing Address
First Line : 227 KIMBERLY LN
Second Line :
City : EPHRATA
State : PA
Zip : 17522-9740
Country : US
Telephone Number : 717-733-5395
Fax Number :
Provider Business Practice Location Address
First Line : 544 N PENRYN RD
Second Line :
City : MANHEIM
State : PA
Zip : 17545-8562
Country : US
Telephone Number : 717-664-6350
Fax Number : 717-664-6382
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2007
Last Update Date : 07/08/2007

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Directions to “ MRS. ELIZABETH ANN BERG SLP” Practice Location

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