Provider Demographics
NPI:1255560843
Name:SPERA, DUBRAVKA (MS, CCC- SLP, CBIS)
Entity type:Individual
Prefix:
First Name:DUBRAVKA
Middle Name:
Last Name:SPERA
Suffix:
Gender:F
Credentials:MS, CCC- SLP, CBIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 QUAIL DR S
Mailing Address - Street 2:
Mailing Address - City:PHOENIXVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19460-1076
Mailing Address - Country:US
Mailing Address - Phone:267-664-6129
Mailing Address - Fax:
Practice Address - Street 1:42 QUAIL DR S
Practice Address - Street 2:
Practice Address - City:PHOENIXVILLE
Practice Address - State:PA
Practice Address - Zip Code:19460-1076
Practice Address - Country:US
Practice Address - Phone:267-664-6129
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-06
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PASL009785235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAGEA4048549800OtherINDEPENDENCE BLUE CROSS