Provider Demographics
NPI:1326324203
Name:MANNO, GRACE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:
Last Name:MANNO
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:GRACE
Other - Middle Name:
Other - Last Name:BAUER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:156 GREEN ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-4906
Mailing Address - Country:US
Mailing Address - Phone:814-594-3709
Mailing Address - Fax:
Practice Address - Street 1:156 GREEN ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-4906
Practice Address - Country:US
Practice Address - Phone:814-594-3709
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-24
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL010558235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist