Provider Demographics
NPI:1689335838
Name:MCNUTT, GIANNA NICOLE (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:GIANNA
Middle Name:NICOLE
Last Name:MCNUTT
Suffix:
Gender:
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 LONGACRE DR
Mailing Address - Street 2:
Mailing Address - City:COLLEGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19426-3811
Mailing Address - Country:US
Mailing Address - Phone:610-745-8640
Mailing Address - Fax:
Practice Address - Street 1:48 LONGACRE DR
Practice Address - Street 2:
Practice Address - City:COLLEGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:19426-3811
Practice Address - Country:US
Practice Address - Phone:610-745-8640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-09
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
235Z00000X
FLSZ10501235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist