Provider Demographics
NPI:1154661304
Name:VANNEST, DEVONA SUE (MS)
Entity Type:Individual
Prefix:
First Name:DEVONA
Middle Name:SUE
Last Name:VANNEST
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 MOUNT VERNON AVE
Mailing Address - Street 2:HUNTINGDON COUNTY PRIDE, INC
Mailing Address - City:HUNTINGDON
Mailing Address - State:PA
Mailing Address - Zip Code:16652-1149
Mailing Address - Country:US
Mailing Address - Phone:814-643-5724
Mailing Address - Fax:814-643-6085
Practice Address - Street 1:1301 MOUNT VERNON AVE
Practice Address - Street 2:HUNTINGDON COUNTY PRIDE, INC
Practice Address - City:HUNTINGDON
Practice Address - State:PA
Practice Address - Zip Code:16652-1149
Practice Address - Country:US
Practice Address - Phone:814-643-5724
Practice Address - Fax:814-643-6085
Is Sole Proprietor?:No
Enumeration Date:2013-02-26
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL000416L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist