Provider Demographics
NPI:1558611400
Name:EINHORN, ELLEN AUERBACH (MA, CCC, SLP)
Entity Type:Individual
Prefix:MS
First Name:ELLEN
Middle Name:AUERBACH
Last Name:EINHORN
Suffix:
Gender:F
Credentials:MA, CCC, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1129 COVENTRY RD
Mailing Address - Street 2:
Mailing Address - City:CHELTENHAM
Mailing Address - State:PA
Mailing Address - Zip Code:19012-1003
Mailing Address - Country:US
Mailing Address - Phone:215-635-1823
Mailing Address - Fax:
Practice Address - Street 1:1129 COVENTRY RD
Practice Address - Street 2:
Practice Address - City:CHELTENHAM
Practice Address - State:PA
Practice Address - Zip Code:19012-1003
Practice Address - Country:US
Practice Address - Phone:215-635-1823
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-18
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL002525L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
00539163OtherASHA CERTIICATE OF CLINICAL COMPETENCE
PASL002525LOtherPENNSYLVANIA STATE LICENSE