Provider Demographics
NPI:1053469163
Name:MURPHY, LINDA K (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:K
Last Name:MURPHY
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 1:53 DANE ST
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-4601
Mailing Address - Country:US
Mailing Address - Phone:617-930-3735
Mailing Address - Fax:617-273-0814
Practice Address - Street 1:53 DANE ST
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-4601
Practice Address - Country:US
Practice Address - Phone:617-930-3735
Practice Address - Fax:617-273-0814
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5507235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MASP 0109OtherBCBSMA PROVIDER NUMBER