Nancy Jean Antonino, CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Greenville, PA

NPI 1265670517 · NPPES record last updated Jan 25, 2009

Key facts

NPI
1265670517
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
SL001083L (PA)
Practice address
110 N Main St
Greenville, PA 16125-1726
Phone
(724) 588-3001
Fax
(724) 588-9620
NPI assigned
Jan 25, 2009
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2245OHMDSpeech-Language Pathologist
SL001083LPAMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SL001083L PA Yes
Speech-Language Pathologist 235Z00000X 2245 OH

Addresses

Primary practice location

110 N Main St
Greenville, PA 16125-1726

Mailing address

1989 Parkview Blvd
Hermitage, PA 16148-1578
Phone (724) 981-6856

Other names

  • Prof. Nancy Jean Antonino Professional name

Other providers in Greenville, PA

All providers in Greenville, PA · Speech-Language Pathologist in Pennsylvania

Sources for this page

Verify at the official NPI Registry.