Provider Demographics
NPI:1063753937
Name:VASELLI, PATRICIA MASSARO (MA, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:MASSARO
Last Name:VASELLI
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 1:1041 BUCKTAIL WAY
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382-2332
Mailing Address - Country:US
Mailing Address - Phone:610-793-6871
Mailing Address - Fax:
Practice Address - Street 1:200 SKILES BLVD
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19382-7321
Practice Address - Country:US
Practice Address - Phone:610-455-4040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-01
Last Update Date:2013-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL009631235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist