MEDICARE: CATHERINE ASTORE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2355S0801X	Speech-Language Assistant	275	MA

General Provider Information

NPI Number	:	1154648137
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHERINE ASTORE

Provider Business Mailing Address
First Line	:	PO BOX 30
Second Line	:	293 MAIN STREET SUITE 303
City	:	GREAT BARRINGTON
State	:	MA
Zip	:	01230-0030
Country	:	US
Telephone Number	:	413-528-9311
Fax Number	:

Provider Business Practice Location Address
First Line	:	442 STOCKBRIDGE RD
Second Line	:
City	:	GREAT BARRINGTON
State	:	MA
Zip	:	01230-1295
Country	:	US
Telephone Number	:	413-644-0104
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/29/2010
Last Update Date	:	04/29/2010

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Directions to “ CATHERINE ASTORE ” Practice Location

Language	Start Address	Practice Location

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