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General NPI Number Information
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NPI Number | 1821247701
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Entity Type | Individual
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Provider Name | ERICA LYNNE SORBER-DAUB
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Gender | Female
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Dates
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Enumeration Date | 09/16/2008
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Last Update Date | 09/16/2008
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Provider Practice Location Address
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Address Line | 190 WELLES ST
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City | FORTY FORT
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State | PA
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Zip | 18704-4968
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Country | US
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Telephone | 570-283-0524
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Fax |
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Provider Business Mailing Address
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Address Line | 1099 SHICKSHINNY VALLEY RD
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City | SHICKSHINNY
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State | PA
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Zip | 18655-2815
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Country | US
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Telephone | 570-542-2355
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | SL007302
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License Number State | PA
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