Provider Demographics
NPI:1225232358
Name:LIPSCHULTZ, ROCHELLE W
Entity Type:Individual
Prefix:
First Name:ROCHELLE
Middle Name:W
Last Name:LIPSCHULTZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 DAVIS AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02445-6006
Mailing Address - Country:US
Mailing Address - Phone:617-824-8314
Mailing Address - Fax:
Practice Address - Street 1:120 BOYLSTON ST
Practice Address - Street 2:DEPT. OF COMMUNICATION SCIENCES AND DISORDERS
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-4611
Practice Address - Country:US
Practice Address - Phone:617-824-8314
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA847235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist