Provider Demographics
NPI:1770781965
Name:ACKER-BAILEY, PATRICIA
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:ACKER-BAILEY
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 1:5243 TERRACE RD
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050-6813
Mailing Address - Country:US
Mailing Address - Phone:717-497-7157
Mailing Address - Fax:717-737-5246
Practice Address - Street 1:5243 TERRACE RD
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050-6813
Practice Address - Country:US
Practice Address - Phone:717-497-7157
Practice Address - Fax:717-737-5246
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2016-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL002537L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist