Provider Demographics
NPI:1700904687
Name:MANCINI, DARLENE ANN
Entity Type:Individual
Prefix:
First Name:DARLENE
Middle Name:ANN
Last Name:MANCINI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 EDMONDS AVE # 3
Mailing Address - Street 2:
Mailing Address - City:DREXEL HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19026-2301
Mailing Address - Country:US
Mailing Address - Phone:610-284-3953
Mailing Address - Fax:
Practice Address - Street 1:409 EDMONDS AVE # 3
Practice Address - Street 2:
Practice Address - City:DREXEL HILL
Practice Address - State:PA
Practice Address - Zip Code:19026-2301
Practice Address - Country:US
Practice Address - Phone:610-284-3953
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASLOO4542L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist