Provider Demographics
NPI:1073794848
Name:UNGER, MARIA T (MA CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:T
Last Name:UNGER
Suffix:
Gender:F
Credentials:MA CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3605 STATE RD
Mailing Address - Street 2:
Mailing Address - City:DREXEL HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19026-2525
Mailing Address - Country:US
Mailing Address - Phone:610-308-5212
Mailing Address - Fax:610-859-0367
Practice Address - Street 1:3200 CONCORD RD
Practice Address - Street 2:SUITE 103
Practice Address - City:ASTON
Practice Address - State:PA
Practice Address - Zip Code:19014-1931
Practice Address - Country:US
Practice Address - Phone:610-416-9556
Practice Address - Fax:610-859-0367
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-20
Last Update Date:2007-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL005484L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019398130004Medicaid