Provider Demographics
NPI:1053804203
Name:NOVELLI, EILEEN (CCC-SLP)
Entity type:Individual
Prefix:
First Name:EILEEN
Middle Name:
Last Name:NOVELLI
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:EILEEN
Other - Middle Name:MARY
Other - Last Name:MCLAUGHLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:419 PALMERS LN
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19086-6544
Mailing Address - Country:US
Mailing Address - Phone:302-388-1109
Mailing Address - Fax:
Practice Address - Street 1:419 PALMERS LN
Practice Address - Street 2:
Practice Address - City:WALLINGFORD
Practice Address - State:PA
Practice Address - Zip Code:19086-6544
Practice Address - Country:US
Practice Address - Phone:302-388-1109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-12
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE01-0001373235Z00000X
PASL016273235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist