Healthcare Provider Details

I. General information

NPI: 1659732303
Provider Name (Legal Business Name): GELLER AND GROSSMAN SPEECH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2016
Last Update Date: 03/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

454 ROCK GLEN DR
WYNNEWOOD PA
19096-2619
US

IV. Provider business mailing address

454 ROCK GLEN DR
WYNNEWOOD PA
19096-2619
US

V. Phone/Fax

Practice location:
  • Phone: 610-547-1626
  • Fax: 610-642-2325
Mailing address:
  • Phone: 610-547-1626
  • Fax: 610-642-2325

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: BARBARA GELLER
Title or Position: SPEECH PATHOLOGIST
Credential:
Phone: 267-252-9331