Healthcare Provider Details

I. General information

NPI: 1871009571
Provider Name (Legal Business Name): LINDA CAROLE BODEN OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2017
Last Update Date: 12/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 NORTH MEADOWS RD. SPEECH-LANGUAGE-HEARING
MEDFIELD MA
02052-0205
US

IV. Provider business mailing address

5 N MEADOWS RD SPEECH-LANGUAGE & HEARING ASSOCIATES
MEDFIELD MA
02052-2317
US

V. Phone/Fax

Practice location:
  • Phone: 508-359-4532
  • Fax: 508-359-0198
Mailing address:
  • Phone: 508-359-4532
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number1526
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: