Provider Demographics
NPI:1225720444
Name:MCCUBREY, EMILEE ROSE
Entity Type:Individual
Prefix:
First Name:EMILEE
Middle Name:ROSE
Last Name:MCCUBREY
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 1:5 HAZEL AVE
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01545-1211
Mailing Address - Country:US
Mailing Address - Phone:508-523-6080
Mailing Address - Fax:
Practice Address - Street 1:15 BARTON ST
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MA
Practice Address - Zip Code:01540-2187
Practice Address - Country:US
Practice Address - Phone:508-499-2178
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-25
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA78026235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist