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General NPI Number Information
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NPI Number | 1396357539
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Entity Type | Individual
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Provider Name | MAUREEN WHITTEMORE MOYNIHAN CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 08/19/2020
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Last Update Date | 08/19/2020
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Provider Practice Location Address
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Address Line | 4901 N MAIN ST
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City | FALL RIVER
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State | MA
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Zip | 02720-2080
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Country | US
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Telephone | 508-675-1001
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Fax |
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Provider Business Mailing Address
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Address Line | 8 COLE AVE
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City | PROVIDENCE
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State | RI
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Zip | 02906-4502
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Country | US
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Telephone | 210-632-4624
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 113364
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License Number State | TX
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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 | SP01562
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License Number State | RI
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Taxonomy #3
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 77564
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License Number State | MA
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