Provider Demographics
NPI:1932497153
Name:KEPPLE, PIERCE CONLON (SLP)
Entity Type:Individual
Prefix:MR
First Name:PIERCE
Middle Name:CONLON
Last Name:KEPPLE
Suffix:
Gender:M
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 SCOTT RUN RD
Mailing Address - Street 2:
Mailing Address - City:SYCAMORE
Mailing Address - State:PA
Mailing Address - Zip Code:15364-1528
Mailing Address - Country:US
Mailing Address - Phone:724-499-5059
Mailing Address - Fax:
Practice Address - Street 1:114 SCOTT RUN RD
Practice Address - Street 2:
Practice Address - City:SYCAMORE
Practice Address - State:PA
Practice Address - Zip Code:15364-1528
Practice Address - Country:US
Practice Address - Phone:724-499-5059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-21
Last Update Date:2011-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL010106235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist