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General NPI Number Information
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NPI Number | 1013294818
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Entity Type | Organization
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Legal Business Name | CHILD TALK
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Dates
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Enumeration Date | 11/08/2011
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Last Update Date | 04/17/2020
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Provider Practice Location Address
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Address Line | 271 LINCOLN ST SUITE 1
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City | LEXINGTON
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State | MA
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Zip | 02421
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Country | US
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Telephone | 617-497-9222
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Fax | 617-497-0422
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Provider Business Mailing Address
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Address Line | 271 LINCOLN ST SUITE 1
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City | LEXINGTON
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State | MA
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Zip | 02421
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Country | US
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Telephone | 617-497-9222
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Fax | 617-497-0422
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. ANN E DENSMORE
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Credential | ED.D., CCC SLP/A
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Telephone | 617-497-9222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 4050
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 3542
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License Number State | MA
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