Provider Demographics
NPI:1316069222
Name:LAMARQUE, VERONICA WAYNE (MA CCC SLP)
Entity type:Individual
Prefix:MISS
First Name:VERONICA
Middle Name:WAYNE
Last Name:LAMARQUE
Suffix:
Gender:F
Credentials:MA CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:4 LELAND HILL ROAD
Mailing Address - Street 2:
Mailing Address - City:SUTTON
Mailing Address - State:MA
Mailing Address - Zip Code:01590-4800
Mailing Address - Country:US
Mailing Address - Phone:508-981-7779
Mailing Address - Fax:
Practice Address - Street 1:237 MILLBURY STREET
Practice Address - Street 2:PERNET FAMILY HEALTH SERVICE
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01610
Practice Address - Country:US
Practice Address - Phone:508-755-1228
Practice Address - Fax:508-797-3477
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3416235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist