Provider Demographics
NPI:1093078081
Name:DUDLEY, MAURA KATHLEEN (AUD)
Entity Type:Individual
Prefix:MRS
First Name:MAURA
Middle Name:KATHLEEN
Last Name:DUDLEY
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:MAURA
Other - Middle Name:KATHLEEN
Other - Last Name:O'ROURKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13 GROVE ST
Mailing Address - Street 2:APT. 8
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-3462
Mailing Address - Country:US
Mailing Address - Phone:860-716-4542
Mailing Address - Fax:
Practice Address - Street 1:825 WASHINGTON ST
Practice Address - Street 2:SUITE 310
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-3441
Practice Address - Country:US
Practice Address - Phone:781-769-8910
Practice Address - Fax:781-255-9844
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MASP-985-AU231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist