Provider Demographics
NPI:1386538148
Name:BATES, KAMI ELLEN
Entity type:Individual
Prefix:
First Name:KAMI
Middle Name:ELLEN
Last Name:BATES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KAMI
Other - Middle Name:
Other - Last Name:FRANCIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:13 VINAL AVE UNIT 1L
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02143-1806
Mailing Address - Country:US
Mailing Address - Phone:617-297-8621
Mailing Address - Fax:
Practice Address - Street 1:13 VINAL AVE UNIT 1L
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02143-1806
Practice Address - Country:US
Practice Address - Phone:617-297-8621
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-05
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MASLP100723235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist