Provider Demographics
NPI:1316019144
Name:MARYWOOD UNIVERSITY
Entity Type:Organization
Organization Name:MARYWOOD UNIVERSITY
Other - Org Name:MARYWOOD UNIVERSITY AUDIOLOGY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT BUSINESS AFFAIRS
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCHALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-348-6222
Mailing Address - Street 1:2300 ADAMS AVE.
Mailing Address - Street 2:MCGOWAN CENTER
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18509-1598
Mailing Address - Country:US
Mailing Address - Phone:570-348-6299
Mailing Address - Fax:570-961-4708
Practice Address - Street 1:2300 ADAMS AVE
Practice Address - Street 2:MCGOWAN CENTER
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18509-1598
Practice Address - Country:US
Practice Address - Phone:570-348-6299
Practice Address - Fax:570-961-4708
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2017-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty