MEDICARE: ANITA RAFFERTY M.S., CCC-SLP

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	4327	MA

General Provider Information

NPI Number	:	1760674428
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANITA RAFFERTY M.S., CCC-SLP

Provider Business Mailing Address
First Line	:	10 PLEASANT CIR
Second Line	:
City	:	CANTON
State	:	MA
Zip	:	02021-2612
Country	:	US
Telephone Number	:	508-922-7121
Fax Number	:

Provider Business Practice Location Address
First Line	:	10 PLEASANT CIR
Second Line	:
City	:	CANTON
State	:	MA
Zip	:	02021-2612
Country	:	US
Telephone Number	:	508-922-7121
Fax Number	:

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

Provider Enumeration Date	:	08/15/2007
Last Update Date	:	08/15/2007

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