Provider Demographics
NPI:1386389948
Name:SPEECH-LANGUAGE AND HEARING ASSOCIATES OF GREATER BOSTON, PC
Entity type:Organization
Organization Name:SPEECH-LANGUAGE AND HEARING ASSOCIATES OF GREATER BOSTON, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MAURA
Authorized Official - Middle Name:G
Authorized Official - Last Name:MARKS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, AUD
Authorized Official - Phone:508-359-4532
Mailing Address - Street 1:5 N MEADOWS RD
Mailing Address - Street 2:
Mailing Address - City:MEDFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02052-2317
Mailing Address - Country:US
Mailing Address - Phone:508-359-4532
Mailing Address - Fax:508-359-0198
Practice Address - Street 1:5 N MEADOWS RD
Practice Address - Street 2:
Practice Address - City:MEDFIELD
Practice Address - State:MA
Practice Address - Zip Code:02052-2317
Practice Address - Country:US
Practice Address - Phone:508-359-4532
Practice Address - Fax:508-359-0198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-28
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty