Provider Demographics
NPI:1831332006
Name:POPE, PATRICIA A (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:A
Last Name:POPE
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 KENSINGTON CT
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:NY
Mailing Address - Zip Code:14487-9762
Mailing Address - Country:US
Mailing Address - Phone:585-750-9397
Mailing Address - Fax:
Practice Address - Street 1:101 KENSINGTON CT
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:NY
Practice Address - Zip Code:14487-9762
Practice Address - Country:US
Practice Address - Phone:585-750-9397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-16
Last Update Date:2009-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008139-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist