Tara Jane Vybiral
Individual provider Active NPI Speech-Language Pathologist · Ambridge, PA
NPI 1679738686 · NPPES record last updated Jul 20, 2008
Key facts
- NPI
- 1679738686
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- SL009201 (PA)
- Practice address
- 3030 Woodland Rd
Ambridge, PA 15003-1348 - Phone
- (724) 318-8184
- NPI assigned
- Jul 20, 2008
- 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 |
|---|---|---|---|
| SL009201 | PA | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SL009201 | PA | Yes |
Addresses
Primary practice location
3030 Woodland Rd
Ambridge, PA 15003-1348
Mailing address
3030 Woodland Rd
Ambridge, PA 15003-1348
Phone (724) 318-8184
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All providers in Ambridge, 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 Jul 20, 2008. 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.