MEDICARE: MRS. TOBY SUE CALANDRA MA CCC SLP

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	SL006461L	PA

General Provider Information

NPI Number	:	1972728491
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TOBY SUE CALANDRA MA CCC SLP

Provider Business Mailing Address
First Line	:	5029 COPLEY RD
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19144-4802
Country	:	US
Telephone Number	:	215-882-2790
Fax Number	:

Provider Business Practice Location Address
First Line	:	5029 COPLEY RD
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19144-4802
Country	:	US
Telephone Number	:	215-882-2790
Fax Number	:

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

Provider Enumeration Date	:	04/17/2007
Last Update Date	:	07/22/2013

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