Provider Demographics
NPI:1447074752
Name:PERRELLI, AUDREY
Entity type:Individual
Prefix:
First Name:AUDREY
Middle Name:
Last Name:PERRELLI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4136 W TILGHMAN ST
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-4428
Mailing Address - Country:US
Mailing Address - Phone:484-822-6040
Mailing Address - Fax:
Practice Address - Street 1:4136 W TILGHMAN ST
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-4428
Practice Address - Country:US
Practice Address - Phone:484-822-6040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-13
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPSL002591235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist