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General NPI Number Information
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NPI Number | 1770930331
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Entity Type | Individual
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Provider Name | SUZANNE MARIE WELLS MA SLP CCC
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Gender | Female
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Dates
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Enumeration Date | 05/24/2016
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Last Update Date | 10/05/2021
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Provider Practice Location Address
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Address Line | 25 HERD DRIVE
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City | IPSWICH
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State | MA
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Zip | 01938
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Country | US
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Telephone | 978-376-0822
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Fax | 978-312-6630
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Provider Business Mailing Address
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Address Line | 25 HERD DRIVE
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City | IPSWICH
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State | MA
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Zip | 01938
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Country | US
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Telephone | 978-376-0822
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Fax | 978-312-6630
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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 |
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License Number State |
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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 | 76481
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License Number State | MA
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