Basic Information
Provider Information
NPI: 1033157862
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KESSLER
FirstName: MARJORIE
MiddleName: RUTH
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: RIDGWAY-POON
OtherFirstName: MARJORIE
OtherMiddleName: RUTH
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 2112 HARRISBURG PIKE
Address2: STE 2
City: LANCASTER
State: PA
PostalCode: 176012644
CountryCode: US
TelephoneNumber: 7175440327
FaxNumber: 7175440330
Practice Location
Address1: 2112 HARRISBURG PIKE STE 2
Address2:  
City: LANCASTER
State: PA
PostalCode: 176012644
CountryCode: US
TelephoneNumber: 7175440327
FaxNumber: 7175440330
Other Information
ProviderEnumerationDate: 06/03/2006
LastUpdateDate: 05/27/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
231H00000XAT005911PAY Speech, Language and Hearing Service ProvidersAudiologist 

No ID Information.


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