Provider Demographics
NPI:1356729248
Name:CAMPAGNA, ELISA (MA CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:ELISA
Middle Name:
Last Name:CAMPAGNA
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 1:300 E WINCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-2250
Mailing Address - Country:US
Mailing Address - Phone:888-531-2204
Mailing Address - Fax:855-232-8604
Practice Address - Street 1:300 E WINCHESTER AVE
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-2250
Practice Address - Country:US
Practice Address - Phone:888-531-2204
Practice Address - Fax:855-232-8604
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-11
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL012133235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist