Healthcare Provider Details

I. General information

NPI: 1124343348
Provider Name (Legal Business Name): DEBORAH KAY MEASE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2010
Last Update Date: 03/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

933 ROUTE 212
RICHLANDTOWN PA
18955-1049
US

IV. Provider business mailing address

933 ROUTE 212
RICHLANDTOWN PA
18955-1049
US

V. Phone/Fax

Practice location:
  • Phone: 267-733-3308
  • Fax:
Mailing address:
  • Phone: 267-733-3308
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSL002223L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: