Provider Demographics
NPI:1467922112
Name:MCGONIGLE, NATALIE KATLYN
Entity Type:Individual
Prefix:MS
First Name:NATALIE
Middle Name:KATLYN
Last Name:MCGONIGLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:232 N LYNN BLVD
Mailing Address - Street 2:
Mailing Address - City:UPPER DARBY
Mailing Address - State:PA
Mailing Address - Zip Code:19082-1231
Mailing Address - Country:US
Mailing Address - Phone:610-609-6581
Mailing Address - Fax:
Practice Address - Street 1:735 MEETING HOUSE RD
Practice Address - Street 2:
Practice Address - City:HOCKESSIN
Practice Address - State:DE
Practice Address - Zip Code:19707-8508
Practice Address - Country:US
Practice Address - Phone:302-239-3420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-26
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEO1-0001705235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist