Basic Information
Provider Information | |||||||||
NPI: | 1437374220 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | HARDING | ||||||||
FirstName: | ELIZABETH | ||||||||
MiddleName: | SUSAN | ||||||||
NamePrefix: | MS. | ||||||||
NameSuffix: |   | ||||||||
Credential: | MS CCCSLP | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: | MAURER | ||||||||
OtherFirstName: | ELIZABETH | ||||||||
OtherMiddleName: | SUSAN | ||||||||
OtherNamePrefix: | MISS | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: | MS CCCSLP | ||||||||
OtherLastNameType: | 1 | ||||||||
Mailing Information | |||||||||
Address1: | 350 SOUTH MAIN STREET | ||||||||
Address2: | SUITE 315 INVO HEALTHCARE ASSOCIATES | ||||||||
City: | DOYLESTOWN | ||||||||
State: | PA | ||||||||
PostalCode: | 18901 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 2154898760 | ||||||||
FaxNumber: | 2154898766 | ||||||||
Practice Location | |||||||||
Address1: | 350 SOUTH MAIN ST | ||||||||
Address2: | SUITE 315 INVO HEALTHCARE ASSOCIATES | ||||||||
City: | DOYLESTOWN | ||||||||
State: | PA | ||||||||
PostalCode: | 18901 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 2154898760 | ||||||||
FaxNumber: | 2154898766 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 04/16/2007 | ||||||||
LastUpdateDate: | 07/08/2007 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | SL001547L | PA | Y |   | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |   |
ID Information
ID | Type | State | Issuer | Description | 1018482010001 | 01 | PA | MA NUMBER | OTHER |