MEDICARE: MISS HELENA ROSA PEREIRA M.A. CCC/SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	6925	MA

General Provider Information

NPI Number	:	1730327081
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS HELENA ROSA PEREIRA M.A. CCC/SLP

Provider Business Mailing Address
First Line	:	67 MOTYKA ST
Second Line	:
City	:	LUDLOW
State	:	MA
Zip	:	01056-2127
Country	:	US
Telephone Number	:	215-688-0913
Fax Number	:

Provider Business Practice Location Address
First Line	:	95 POST OFFICE PARK
Second Line	:
City	:	WILBRAHAM
State	:	MA
Zip	:	01095-1248
Country	:	US
Telephone Number	:	187-745-4371
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/24/2009
Last Update Date	:	01/24/2009

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