Provider Demographics
NPI:1992335087
Name:KRENCY, CHARLOTTE ALICE (CCC-SLP)
Entity type:Individual
Prefix:
First Name:CHARLOTTE
Middle Name:ALICE
Last Name:KRENCY
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 1:25 MCKENNAN AVE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-3530
Mailing Address - Country:US
Mailing Address - Phone:724-288-6922
Mailing Address - Fax:
Practice Address - Street 1:25 MCKENNAN AVE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-3530
Practice Address - Country:US
Practice Address - Phone:724-288-6922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-17
Last Update Date:2020-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL014810235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist