Active NPI
Andria Dalley Fiske, MS CCC-SLP
- Speech-Language Pathologist
- Scranton, PA
National Provider Identifier
1396101648
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SL012662
- Practice address
- 1101 Vine Street
Scranton, PA 18510-2126 - Phone
- (570) 343-7175
- NPI assigned
- Dec 31, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SL012662 | PA | Primary |
Addresses
Primary practice location
1101 Vine Street
Scranton, PA 18510-2126
Mailing address
301 Lake St
Dallas, PA 18612-7752
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SL012662 | PA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1451520000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1508716800000",
"number": "1396101648",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "301 LAKE ST",
"city": "DALLAS",
"state": "PA",
"postal_code": "186127752"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1101 VINE STREET",
"city": "SCRANTON",
"state": "PA",
"postal_code": "185102126",
"telephone_number": "570-343-7175"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FISKE",
"first_name": "ANDRIA",
"middle_name": "DALLEY",
"credential": "MS CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-12-31",
"last_updated": "2017-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "PA",
"license": "SL012662",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Scranton, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.