Provider Demographics
NPI:1013034792
Name:MCCAULEY, PATTI COSMAN (MA)
Entity Type:Individual
Prefix:MS
First Name:PATTI
Middle Name:COSMAN
Last Name:MCCAULEY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 LORIMER ST
Mailing Address - Street 2:
Mailing Address - City:INDIAN ORCHARD
Mailing Address - State:MA
Mailing Address - Zip Code:01151-1817
Mailing Address - Country:US
Mailing Address - Phone:413-732-9978
Mailing Address - Fax:
Practice Address - Street 1:68 LORIMER ST
Practice Address - Street 2:
Practice Address - City:INDIAN ORCHARD
Practice Address - State:MA
Practice Address - Zip Code:01151-1817
Practice Address - Country:US
Practice Address - Phone:413-732-9978
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1742196235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist