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General NPI Number Information
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NPI Number | 1124375332
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Entity Type | Organization
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Legal Business Name | NORFOLK COUNTY SPEECH SERVICES
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Dates
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Enumeration Date | 08/07/2012
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Last Update Date | 08/07/2012
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Provider Practice Location Address
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Address Line | 594 NAHATAN ST
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City | NORWOOD
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State | MA
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Zip | 02062-1445
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Country | US
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Telephone | 617-823-9079
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Fax | 781-762-3122
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Provider Business Mailing Address
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Address Line | 450 N MAIN ST
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City | SHARON
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State | MA
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Zip | 02067-1172
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Country | US
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Telephone | 617-823-9079
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Fax | 781-762-3122
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Authorized Official
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Title or Position | OWNER
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Name | MS. KATHLEEN ANNE DAVIS
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Credential | M.A., C.C.C./SLP
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Telephone | 617-823-9079
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 2214
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License Number State | MA
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