Provider Demographics
NPI:1528011046
Name:MAQBOOL, MAHNAZ NASEEM (SLP)
Entity Type:Individual
Prefix:
First Name:MAHNAZ
Middle Name:NASEEM
Last Name:MAQBOOL
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:638 BRANDYWINE PKWY
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-4278
Mailing Address - Country:US
Mailing Address - Phone:610-436-3600
Mailing Address - Fax:610-436-3606
Practice Address - Street 1:3434 GARRETT RD
Practice Address - Street 2:
Practice Address - City:DREXEL HILL
Practice Address - State:PA
Practice Address - Zip Code:19026-2941
Practice Address - Country:US
Practice Address - Phone:610-803-0100
Practice Address - Fax:610-803-0103
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL008030235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist