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General NPI Number Information
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NPI Number | 1598070385
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Entity Type | Organization
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Legal Business Name | SPEECH & COUNSELING SERVICES OF BRYN MAWR, LLC.
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Dates
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Enumeration Date | 08/17/2010
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Last Update Date | 08/17/2010
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Provider Practice Location Address
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Address Line | 212 LEE CIR
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City | BRYN MAWR
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State | PA
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Zip | 19010-3726
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Country | US
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Telephone | 610-745-0590
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Fax |
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Provider Business Mailing Address
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Address Line | 212 LEE CIR
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City | BRYN MAWR
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State | PA
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Zip | 19010-3726
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Country | US
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Telephone | 610-745-0590
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Fax |
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | VANESSA PADDOCK
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Credential |
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Telephone | 610-745-0590
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SL007567
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License Number State | PA
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