MEDICARE: KATHERINE LABOSSIERE

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	235Z00000X	Speech-Language Pathologist	9722	MA

General Provider Information

NPI Number	:	1700258845
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE LABOSSIERE

Provider Business Mailing Address
First Line	:	100 CUMMINGS CTR STE 135H
Second Line	:
City	:	BEVERLY
State	:	MA
Zip	:	01915-6127
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 CUMMINGS CTR STE 135H
Second Line	:
City	:	BEVERLY
State	:	MA
Zip	:	01915-6127
Country	:	US
Telephone Number	:	978-927-0172
Fax Number	:

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

Provider Enumeration Date	:	10/28/2015
Last Update Date	:	10/28/2015

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Directions to “ KATHERINE LABOSSIERE ” Practice Location

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