Provider Demographics
NPI:1578905949
Name:REARDEN, EILEEN MARIE (MA, CCC/SLP)
Entity Type:Individual
Prefix:MS
First Name:EILEEN
Middle Name:MARIE
Last Name:REARDEN
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 1:201 LONGLEAF DR
Mailing Address - Street 2:
Mailing Address - City:BLANDON
Mailing Address - State:PA
Mailing Address - Zip Code:19510-9405
Mailing Address - Country:US
Mailing Address - Phone:610-926-3639
Mailing Address - Fax:
Practice Address - Street 1:2101 STATE HILL RD
Practice Address - Street 2:SUITE 4
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-1993
Practice Address - Country:US
Practice Address - Phone:484-628-0302
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-25
Last Update Date:2013-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL003425L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist