Provider Demographics
NPI:1275719700
Name:LABELLA, PATRICIA A (CCC-SLP)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:A
Last Name:LABELLA
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2685 EXECUTIVE PARK DR STE 5
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33331-3651
Mailing Address - Country:US
Mailing Address - Phone:954-372-9710
Mailing Address - Fax:
Practice Address - Street 1:2685 EXECUTIVE PARK DR STE 5
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33331-3651
Practice Address - Country:US
Practice Address - Phone:954-372-9710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 9287235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist