Provider Demographics
NPI:1558560557
Name:MORAN, LYNN RYAN (SLP)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:RYAN
Last Name:MORAN
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:PO BOX 307
Mailing Address - Street 2:3666 WILHELM ROAD
Mailing Address - City:HELLERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18055-0307
Mailing Address - Country:US
Mailing Address - Phone:610-838-7969
Mailing Address - Fax:610-838-2273
Practice Address - Street 1:1 N BELFIELD AVE
Practice Address - Street 2:SUNNY DAYS
Practice Address - City:HAVERTOWN
Practice Address - State:PA
Practice Address - Zip Code:19083-4904
Practice Address - Country:US
Practice Address - Phone:610-449-1600
Practice Address - Fax:610-449-2655
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-11
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL000709L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist