Healthcare Provider Details

I. General information

NPI: 1164693743
Provider Name (Legal Business Name): BARBARA JEAN MAGEE MSCCCSLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2008
Last Update Date: 03/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7051 PASSYUNK AVE
PHILADELPHIA PA
19142-1724
US

IV. Provider business mailing address

7051 PASSYUNK AVE
PHILADELPHIA PA
19142-1724
US

V. Phone/Fax

Practice location:
  • Phone: 215-492-1079
  • Fax: 215-492-1083
Mailing address:
  • Phone: 215-492-1079
  • Fax: 215-492-1083

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License NumberSL006172L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: