Provider Demographics
NPI:1073171526
Name:TEREFENKO, MAGGIE (SLP CCC)
Entity Type:Individual
Prefix:
First Name:MAGGIE
Middle Name:
Last Name:TEREFENKO
Suffix:
Gender:F
Credentials:SLP CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:THE CENTER FOR PEDIATRIC THERAPY INC
Mailing Address - Street 2:9 BRISTOL CT
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610
Mailing Address - Country:US
Mailing Address - Phone:610-670-8600
Mailing Address - Fax:610-670-9104
Practice Address - Street 1:THE CENTER FOR PEDIATRIC THERAPY INC
Practice Address - Street 2:9 BRISTOL CT
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610
Practice Address - Country:US
Practice Address - Phone:610-670-8600
Practice Address - Fax:610-670-9104
Is Sole Proprietor?:No
Enumeration Date:2019-05-30
Last Update Date:2019-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA235Z00000X235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist