Mia Kathryn Retter, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SL016570 Issued in PA

Practice address

2473 Grant Ave
Philadelphia, PA 19114-1004

Phone

(445) 300-7220

NPI assigned

May 28, 2024

Last updated

May 28, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Theraplay, LLC

  • Occupational Therapist
  • West Chester, PA
  • NPI 1720068489

  Speech-Language Pathologist

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1716854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1568202547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 PIERMONT ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191163419",
            "telephone_number": "267-226-2006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2473 GRANT AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191141004",
            "telephone_number": "445-300-7220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RETTER",
        "first_name": "MIA",
        "middle_name": "KATHRYN",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-28",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL016570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Retap Life PLLC
• Leah B Rethy, MD
• Jennifer Retig, PA
• Retina Diagnostic & Treatment Associates, LLC
• Michele Retrouvey, MD
• Jordan Rettig, M.D.
• Patricia Ann Rettig, RN CRNP
• Richard Rettig, D.P.M.
• Return to New, Inc (My Family Transit)
• Christine L. Reustle, CPNP

• Speech-Language Pathologist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Speech-Language Pathologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.