Provider Demographics
NPI:1114206125
Name:SPECE, TRISHA L (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:TRISHA
Middle Name:L
Last Name:SPECE
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:TRISHA
Other - Middle Name:L
Other - Last Name:DENNY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:406 WARBURTON AVE APT 1N
Mailing Address - Street 2:
Mailing Address - City:HASTINGS ON HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:10706-2819
Mailing Address - Country:US
Mailing Address - Phone:412-608-4857
Mailing Address - Fax:
Practice Address - Street 1:4466 WILLIAM PENN HWY
Practice Address - Street 2:
Practice Address - City:MURRYSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15668-1900
Practice Address - Country:US
Practice Address - Phone:724-304-0030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-08
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021299-1235Z00000X
PA021299-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1035998850001Medicaid
PA251891826OtherREHABILITATION INNOVATIONS, INC