Healthcare Provider Details

I. General information

NPI: 1851098727
Provider Name (Legal Business Name): ROSEANITA SCHUBERT HURLEY SLP-CCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2023
Last Update Date: 02/13/2023
Certification Date: 02/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

316 SAINT DAVIDS RD
WAYNE PA
19087-4307
US

IV. Provider business mailing address

316 SAINT DAVIDS RD
WAYNE PA
19087-4307
US

V. Phone/Fax

Practice location:
  • Phone: 484-547-6299
  • Fax:
Mailing address:
  • Phone: 484-547-6299
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSL016154
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: