Healthcare Provider Details
I. General information
NPI: 1043453210
Provider Name (Legal Business Name): KEIRA M EYRE M.S. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/16/2009
Last Update Date: 04/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
265 N CALDWELL CIR
DOWNINGTOWN PA
19335-4969
US
IV. Provider business mailing address
265 N CALDWELL CIR
DOWNINGTOWN PA
19335-4969
US
V. Phone/Fax
- Phone: 484-999-4925
- Fax:
- Phone: 484-999-4925
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | SL011697 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: