Provider Demographics
NPI:1588216410
Name:ALDRICH, ADRIANA LYNN (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ADRIANA
Middle Name:LYNN
Last Name:ALDRICH
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 1:1217 BRYAN ST
Mailing Address - Street 2:
Mailing Address - City:DREXEL HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19026-1813
Mailing Address - Country:US
Mailing Address - Phone:267-760-3226
Mailing Address - Fax:
Practice Address - Street 1:55 S MEADOWOOD DR
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711-6755
Practice Address - Country:US
Practice Address - Phone:302-454-3400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-11
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEO1-0001756235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist