Provider Demographics
NPI:1508829532
Name:KURTZ, MARIE CERQUA (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MARIE
Middle Name:CERQUA
Last Name:KURTZ
Suffix:
Gender:F
Credentials:MS, CCC-SLP
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Mailing Address - Street 1:500 UNIVERSITY DR
Mailing Address - Street 2:MC A410
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033-2360
Mailing Address - Country:US
Mailing Address - Phone:800-243-1455
Mailing Address - Fax:717-531-7269
Practice Address - Street 1:30 HOPE DR
Practice Address - Street 2:MC EC130
Practice Address - City:HERSHEY
Practice Address - State:PA
Practice Address - Zip Code:17033-2036
Practice Address - Country:US
Practice Address - Phone:717-531-8070
Practice Address - Fax:717-531-4558
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2012-01-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PASL005873L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist