Individual
MS. KERRIE M RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., CCC-SLP
Contact information
Practice address
44 S 38TH ST, CAMP HILL, PA 17011-4307
(717) 975-0611
(717) 975-0839
Mailing address
710 WESTWOOD DR, ENOLA, PA 17025-1528
(717) 728-1844
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SL004872L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0019276430001
MEDICAL ASSISTANCE NUMBER
PA
Enumeration date
05/30/2007
Last updated
07/08/2007
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