Provider Demographics
NPI:1003172123
Name:NOSEK, MOLLEE M (MS CCC/SLP)
Entity Type:Individual
Prefix:MS
First Name:MOLLEE
Middle Name:M
Last Name:NOSEK
Suffix:
Gender:F
Credentials:MS CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 KEYES RD
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:MA
Mailing Address - Zip Code:01503-1655
Mailing Address - Country:US
Mailing Address - Phone:508-494-0450
Mailing Address - Fax:
Practice Address - Street 1:8 KEYES RD
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:MA
Practice Address - Zip Code:01503-1655
Practice Address - Country:US
Practice Address - Phone:508-494-0450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-03
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5007235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist