Healthcare Provider Details

I. General information

NPI: 1881556512
Provider Name (Legal Business Name): EMILY R MANGES SLT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/01/2025
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 WILDWOOD RD
GIBSONIA PA
15044-6404
US

IV. Provider business mailing address

2400 WILDWOOD RD
GIBSONIA PA
15044-6404
US

V. Phone/Fax

Practice location:
  • Phone: 412-487-7771
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSL018901
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: