Basic Information
| Provider Information | |||||||||
| NPI: | 1295082204 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FEEHAN | ||||||||
| FirstName: | TOVAH | ||||||||
| MiddleName: | |||||||||
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| Credential: | SLP | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | ROSENBERG | ||||||||
| OtherFirstName: | TOVAH | ||||||||
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| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | P.O. BOX 191 | ||||||||
| Address2: | |||||||||
| City: | ROCKLAND | ||||||||
| State: | DE | ||||||||
| PostalCode: | 197230191 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3026514000 | ||||||||
| FaxNumber: | 3026514945 | ||||||||
| Practice Location | |||||||||
| Address1: | 443 LAUREL OAK RD | ||||||||
| Address2: | |||||||||
| City: | VOORHEES | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080434419 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8568059368 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/08/2012 | ||||||||
| LastUpdateDate: | 12/11/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 010001399 | DE | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | 235Z00000X | SL010981 | PA | N | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | 235Z00000X | 41YS00789900 | NJ | N | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.