Provider Demographics
NPI:1760684575
Name:UNDERKOFFLER, DENISE (SLP)
Entity Type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:
Last Name:UNDERKOFFLER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2943 KRISTIN CT.
Mailing Address - Street 2:
Mailing Address - City:CENTER VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:18034
Mailing Address - Country:US
Mailing Address - Phone:610-282-9464
Mailing Address - Fax:
Practice Address - Street 1:2943 KRISTIN CT.
Practice Address - Street 2:
Practice Address - City:CENTER VALLEY
Practice Address - State:PA
Practice Address - Zip Code:18034
Practice Address - Country:US
Practice Address - Phone:610-282-9464
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-04
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL008234235Z00000X
CASP 13563235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist