Provider Demographics
NPI:1730921966
Name:O'BRIEN, DEVIN H (MS CF-SLP)
Entity type:Individual
Prefix:
First Name:DEVIN
Middle Name:H
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:MS CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 PENNSYLVANIA AVE APT 1053
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19130-2344
Mailing Address - Country:US
Mailing Address - Phone:215-801-5487
Mailing Address - Fax:
Practice Address - Street 1:8100 WASHINGTON LN
Practice Address - Street 2:
Practice Address - City:WYNCOTE
Practice Address - State:PA
Practice Address - Zip Code:19095-1600
Practice Address - Country:US
Practice Address - Phone:215-576-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-10
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPSL002425235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist