Provider Demographics
NPI:1437455896
Name:FINE, TARYN (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:TARYN
Middle Name:
Last Name:FINE
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:TARYN
Other - Middle Name:
Other - Last Name:TRACHTENBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:722 DIXON LN
Mailing Address - Street 2:
Mailing Address - City:GLADWYNE
Mailing Address - State:PA
Mailing Address - Zip Code:19035-1602
Mailing Address - Country:US
Mailing Address - Phone:215-327-6666
Mailing Address - Fax:
Practice Address - Street 1:221 BELMONT AVE
Practice Address - Street 2:
Practice Address - City:ORELAND
Practice Address - State:PA
Practice Address - Zip Code:19075-1209
Practice Address - Country:US
Practice Address - Phone:610-420-8811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-02
Last Update Date:2017-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL010091235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist