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
| License | State | Type | Specialty |
|---|---|---|---|
| 2245 | OH | MD | Speech-Language Pathologist |
| SL001083L | PA | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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All providers in Greenville, PA · Speech-Language Pathologist in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 25, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.