Provider Demographics
NPI:1609064518
Name:RIVIELLO, ROXANNE M (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ROXANNE
Middle Name:M
Last Name:RIVIELLO
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 ALDEN AVE
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19067-4806
Mailing Address - Country:US
Mailing Address - Phone:215-428-6862
Mailing Address - Fax:
Practice Address - Street 1:206 FLORAL VALE BLVD
Practice Address - Street 2:
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-5524
Practice Address - Country:US
Practice Address - Phone:215-968-8812
Practice Address - Fax:360-364-8812
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-05
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL009015235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist