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

LicenseStateTypeSpecialty
SL009201PAMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
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

Other providers in Ambridge, PA

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

Sources for this page

Verify at the official NPI Registry.