Provider Demographics
NPI:1275787665
Name:WEBB, MAURA KENNEY (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MAURA
Middle Name:KENNEY
Last Name:WEBB
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 1:64 OAK LEDGE LN
Mailing Address - Street 2:
Mailing Address - City:WILTON
Mailing Address - State:CT
Mailing Address - Zip Code:06897-3404
Mailing Address - Country:US
Mailing Address - Phone:203-515-9094
Mailing Address - Fax:203-515-9094
Practice Address - Street 1:2269 SAW MILL RIVER RD
Practice Address - Street 2:
Practice Address - City:ELMSFORD
Practice Address - State:NY
Practice Address - Zip Code:10523-3832
Practice Address - Country:US
Practice Address - Phone:914-592-5600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-11
Last Update Date:2008-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008360235Z00000X
CT003159235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist