Provider Demographics
NPI:1144351354
Name:KLINGENSMITH, JUDY KAY (MS,CCC,SLP)
Entity type:Individual
Prefix:MR
First Name:JUDY
Middle Name:KAY
Last Name:KLINGENSMITH
Suffix:
Gender:F
Credentials:MS,CCC,SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4910 BEECH CT
Mailing Address - Street 2:
Mailing Address - City:SCHNECKSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18078-2900
Mailing Address - Country:US
Mailing Address - Phone:610-799-5050
Mailing Address - Fax:610-799-6099
Practice Address - Street 1:4910 BEECH CT
Practice Address - Street 2:
Practice Address - City:SCHNECKSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18078-2900
Practice Address - Country:US
Practice Address - Phone:610-799-5050
Practice Address - Fax:610-799-6099
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL002839L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007278380006Medicaid