Provider Demographics
NPI:1891139515
Name:EVERS, MAUREEN ELIZABETH (MA, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:MAUREEN
Middle Name:ELIZABETH
Last Name:EVERS
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 1:618 GREEN LN
Mailing Address - Street 2:2ND FLOOR APT.
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19128-2632
Mailing Address - Country:US
Mailing Address - Phone:610-291-8844
Mailing Address - Fax:
Practice Address - Street 1:100 W SCHOOL HOUSE LN
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19144-3404
Practice Address - Country:US
Practice Address - Phone:215-951-4700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-24
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL009079235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist