Provider Demographics
NPI:1750939823
Name:CORAN, MONICA (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:CORAN
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 1:229 HAVERFORD RD
Mailing Address - Street 2:
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-3318
Mailing Address - Country:US
Mailing Address - Phone:610-513-9616
Mailing Address - Fax:610-649-0991
Practice Address - Street 1:50 N MALIN RD
Practice Address - Street 2:
Practice Address - City:BROOMALL
Practice Address - State:PA
Practice Address - Zip Code:19008-1429
Practice Address - Country:US
Practice Address - Phone:610-356-0800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-30
Last Update Date:2019-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL014536235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist