MEDICARE: PATRICIA ACKER-BAILEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	SL002537L	PA

General Provider Information

NPI Number	:	1770781965
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA ACKER-BAILEY

Provider Business Mailing Address
First Line	:	5243 TERRACE RD
Second Line	:
City	:	MECHANICSBURG
State	:	PA
Zip	:	17050-6813
Country	:	US
Telephone Number	:	717-497-7157
Fax Number	:	717-737-5246

Provider Business Practice Location Address
First Line	:	5243 TERRACE RD
Second Line	:
City	:	MECHANICSBURG
State	:	PA
Zip	:	17050-6813
Country	:	US
Telephone Number	:	717-497-7157
Fax Number	:	717-737-5246

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/10/2007
Last Update Date	:	01/29/2016

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Directions to “ PATRICIA ACKER-BAILEY ” Practice Location

Language	Start Address	Practice Location

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