Provider Demographics
NPI:1205871316
Name:CELEBRE, DOROTHY LYNN (MA CCC/SLP)
Entity type:Individual
Prefix:MRS
First Name:DOROTHY
Middle Name:LYNN
Last Name:CELEBRE
Suffix:
Gender:F
Credentials:MA CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 GOLFVIEW RD
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19086-6409
Mailing Address - Country:US
Mailing Address - Phone:610-565-4487
Mailing Address - Fax:610-565-1660
Practice Address - Street 1:10 S PLUM ST
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-3309
Practice Address - Country:US
Practice Address - Phone:610-565-1445
Practice Address - Fax:610-565-1660
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL000269L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0526467000OtherKEYSTONE HEALTHPLAN EAST
PA0526467000OtherBLUE CROSS-BLUE SHIELD
PA0526467000OtherPERSONAL CHOICE
PA32948OtherAETNA