Provider Demographics
NPI:1710544291
Name:MARIA, CECELIA MAURA (CCC-SLP)
Entity type:Individual
Prefix:MISS
First Name:CECELIA
Middle Name:MAURA
Last Name:MARIA
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 1:116 HAYDUK LN
Mailing Address - Street 2:
Mailing Address - City:FACTORYVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18419-7994
Mailing Address - Country:US
Mailing Address - Phone:570-905-5921
Mailing Address - Fax:
Practice Address - Street 1:116 HAYDUK LN
Practice Address - Street 2:
Practice Address - City:FACTORYVILLE
Practice Address - State:PA
Practice Address - Zip Code:18419-7994
Practice Address - Country:US
Practice Address - Phone:570-905-5921
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-21
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA14258936235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist