Healthcare Provider Details

I. General information

NPI: 1629993977
Provider Name (Legal Business Name): BREANNA ELIZABETH WARD MS-CFSLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

324R CLARK ST
WORCESTER MA
01606-1214
US

IV. Provider business mailing address

4 BLUEBERRY WAY
WEBSTER MA
01570-3235
US

V. Phone/Fax

Practice location:
  • Phone: 774-823-1500
  • Fax:
Mailing address:
  • Phone: 774-289-2584
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: