Provider Demographics
NPI:1528245115
Name:PERRETTA, ROSEMARIE A (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:ROSEMARIE
Middle Name:A
Last Name:PERRETTA
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1460 DEER PATH RD.
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18040
Mailing Address - Country:US
Mailing Address - Phone:908-763-0303
Mailing Address - Fax:
Practice Address - Street 1:4670 BERWYN LANE
Practice Address - Street 2:CONNECTIVE INTERVENTION SERVICES
Practice Address - City:MACUNGIE
Practice Address - State:PA
Practice Address - Zip Code:18062
Practice Address - Country:US
Practice Address - Phone:610-909-4051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-25
Last Update Date:2008-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL008996235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist