Provider Demographics
NPI:1699974626
Name:EITELBERG, LOUISE (MA CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:LOUISE
Middle Name:
Last Name:EITELBERG
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 1:8 SILK MILL DR STE 204
Mailing Address - Street 2:
Mailing Address - City:HAWLEY
Mailing Address - State:PA
Mailing Address - Zip Code:18428-1413
Mailing Address - Country:US
Mailing Address - Phone:201-341-2445
Mailing Address - Fax:215-515-0038
Practice Address - Street 1:8 SILK MILL DR STE 204
Practice Address - Street 2:
Practice Address - City:HAWLEY
Practice Address - State:PA
Practice Address - Zip Code:18428-1413
Practice Address - Country:US
Practice Address - Phone:201-231-2445
Practice Address - Fax:215-515-0038
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-11
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00298700235Z00000X
PASL008507235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist