Provider Demographics
NPI:1518257377
Name:FAY, AIMEE LEAH (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:AIMEE
Middle Name:LEAH
Last Name:FAY
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MISS
Other - First Name:AIMEE
Other - Middle Name:LEAH
Other - Last Name:FRITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS
Mailing Address - Street 1:149 S HUNTER HWY
Mailing Address - Street 2:
Mailing Address - City:DRUMS
Mailing Address - State:PA
Mailing Address - Zip Code:18222-2422
Mailing Address - Country:US
Mailing Address - Phone:570-956-6761
Mailing Address - Fax:
Practice Address - Street 1:149 S HUNTER HWY
Practice Address - Street 2:
Practice Address - City:DRUMS
Practice Address - State:PA
Practice Address - Zip Code:18222-2422
Practice Address - Country:US
Practice Address - Phone:570-956-6761
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-13
Last Update Date:2014-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL010880235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist