Provider Demographics
NPI:1659735611
Name:GERBER, PERRY (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:PERRY
Middle Name:
Last Name:GERBER
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1154 HORSESHOE PIKE
Mailing Address - Street 2:
Mailing Address - City:DOWNINGTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19335-1366
Mailing Address - Country:US
Mailing Address - Phone:484-794-1626
Mailing Address - Fax:
Practice Address - Street 1:1154 HORSESHOE PIKE
Practice Address - Street 2:
Practice Address - City:DOWNINGTOWN
Practice Address - State:PA
Practice Address - Zip Code:19335-1366
Practice Address - Country:US
Practice Address - Phone:484-794-1626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-06
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA3501806235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist