Provider Demographics
NPI:1487158630
Name:TREBER, LESA ANN (MS/CCC/SLP)
Entity type:Individual
Prefix:
First Name:LESA
Middle Name:ANN
Last Name:TREBER
Suffix:
Gender:F
Credentials:MS/CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 PORTER AVE
Mailing Address - Street 2:
Mailing Address - City:SCOTTDALE
Mailing Address - State:PA
Mailing Address - Zip Code:15683-1147
Mailing Address - Country:US
Mailing Address - Phone:724-887-0100
Mailing Address - Fax:724-887-6837
Practice Address - Street 1:900 PORTER AVE
Practice Address - Street 2:
Practice Address - City:SCOTTDALE
Practice Address - State:PA
Practice Address - Zip Code:15683-1147
Practice Address - Country:US
Practice Address - Phone:724-887-0100
Practice Address - Fax:724-887-6837
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-22
Last Update Date:2018-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL0003278L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist