Provider Demographics
NPI:1447370994
Name:MONSERRAT, TARA RAE (MA-CCC/SLP-L)
Entity type:Individual
Prefix:MRS
First Name:TARA
Middle Name:RAE
Last Name:MONSERRAT
Suffix:
Gender:F
Credentials:MA-CCC/SLP-L
Other - Prefix:MRS
Other - First Name:TARA
Other - Middle Name:RAE
Other - Last Name:FIORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA-CCC/SLP-L
Mailing Address - Street 1:105 RALEIGH ROAD
Mailing Address - Street 2:
Mailing Address - City:SCHWENKSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19473-2803
Mailing Address - Country:US
Mailing Address - Phone:610-715-5153
Mailing Address - Fax:
Practice Address - Street 1:105 RALEIGH ROAD
Practice Address - Street 2:
Practice Address - City:SCHWENKSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19473-2803
Practice Address - Country:US
Practice Address - Phone:610-715-5153
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL007715235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist