Healthcare Provider Details

I. General information

NPI: 1942270574
Provider Name (Legal Business Name): SPEECH-LANGUAGE AND HEARING ASSOCIATES OF GREATER BOSTON, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2006
Last Update Date: 10/19/2020
Certification Date: 10/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 NORTH MEADOWS RD SLP ASSOCIATES PC
MEDFIELD MA
02052-2317
US

IV. Provider business mailing address

5 NORTH MEADOWS RD SLP ASSOCIATES PC
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: 508-359-0198

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: DR. MAURA G. MARKS
Title or Position: DIRECTOR
Credential: PHD AUD CCC-A/SLP
Phone: 508-359-8158