Provider Demographics
NPI:1235029802
Name:VANCLEEF, BIANCA TAE
Entity type:Individual
Prefix:
First Name:BIANCA
Middle Name:TAE
Last Name:VANCLEEF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:655 N 37TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-1946
Mailing Address - Country:US
Mailing Address - Phone:908-800-3930
Mailing Address - Fax:
Practice Address - Street 1:115 PHEASANT RUN STE 215
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-1886
Practice Address - Country:US
Practice Address - Phone:215-550-6109
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-07
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist