Provider Demographics
NPI:1508011446
Name:NEFF, MARY ELIZABETH (CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:ELIZABETH
Last Name:NEFF
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:MS
Other - First Name:MARY
Other - Middle Name:ELIZABETH
Other - Last Name:ELIAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:692 W BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:WESTOVER
Mailing Address - State:PA
Mailing Address - Zip Code:16692-8310
Mailing Address - Country:US
Mailing Address - Phone:814-247-9251
Mailing Address - Fax:
Practice Address - Street 1:207 OTTAWA ST
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15904-2337
Practice Address - Country:US
Practice Address - Phone:814-262-2152
Practice Address - Fax:814-266-1023
Is Sole Proprietor?:No
Enumeration Date:2008-11-19
Last Update Date:2011-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL009423235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA396822Medicare Oscar/Certification