Provider Demographics
NPI:1265323265
Name:DEIBERT, MIA
Entity type:Individual
Prefix:
First Name:MIA
Middle Name:
Last Name:DEIBERT
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 1:142 BENT TREE DR
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-9436
Mailing Address - Country:US
Mailing Address - Phone:717-681-2520
Mailing Address - Fax:
Practice Address - Street 1:3001 LITITZ PIKE
Practice Address - Street 2:
Practice Address - City:LITITZ
Practice Address - State:PA
Practice Address - Zip Code:17543-9414
Practice Address - Country:US
Practice Address - Phone:717-569-2657
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-09
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist