Healthcare Provider Details

I. General information

NPI: 1750209177
Provider Name (Legal Business Name): TABITHA PICKARD MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

58 HOLLISTON ST
MEDWAY MA
02053-1427
US

IV. Provider business mailing address

58 HOLLISTON ST
MEDWAY MA
02053-1427
US

V. Phone/Fax

Practice location:
  • Phone: 774-571-4361
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP100996
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: