Healthcare Provider Details

I. General information

NPI: 1942748843
Provider Name (Legal Business Name): HANDMADE COMMUNICATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2017
Last Update Date: 02/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

831 OAKMONT AVE
ERIE PA
16505-3243
US

IV. Provider business mailing address

831 OAKMONT AVE
ERIE PA
16505-3243
US

V. Phone/Fax

Practice location:
  • Phone: 814-397-9716
  • Fax:
Mailing address:
  • Phone: 814-397-9716
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License NumberSL010766
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License NumberSL010766
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License NumberSL010766
License Number StatePA

VIII. Authorized Official

Name: CASSANDRA M LUCAS-SZUMIGALA
Title or Position: SPEECH LANGUAGE PATHOLOGIST
Credential: M.S., CCC-SLP
Phone: 814-397-9716