Provider Demographics
NPI:1033533708
Name:MAHAFFEY, KEVIN (MA)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:
Last Name:MAHAFFEY
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 FISHER ST
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02090-3518
Mailing Address - Country:US
Mailing Address - Phone:617-332-7244
Mailing Address - Fax:617-630-8244
Practice Address - Street 1:1298 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:WEST NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02465-2001
Practice Address - Country:US
Practice Address - Phone:617-332-7244
Practice Address - Fax:617-630-8244
Is Sole Proprietor?:No
Enumeration Date:2014-02-14
Last Update Date:2014-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA376231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist