Provider Demographics
NPI:1215180963
Name:DELLEGROTTO, JOHN (EDD CCC SLP)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:DELLEGROTTO
Suffix:
Gender:M
Credentials:EDD CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1703 KATHRYN ST
Mailing Address - Street 2:
Mailing Address - City:NEW CUMBERLAND
Mailing Address - State:PA
Mailing Address - Zip Code:17070
Mailing Address - Country:US
Mailing Address - Phone:717-774-6343
Mailing Address - Fax:717-774-7659
Practice Address - Street 1:1703 KATHRYN ST
Practice Address - Street 2:
Practice Address - City:NEW CUMBERLAND
Practice Address - State:PA
Practice Address - Zip Code:17070
Practice Address - Country:US
Practice Address - Phone:717-774-6343
Practice Address - Fax:717-774-7659
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL000934L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist