Provider Demographics
NPI:1477267052
Name:COMPERCHIO, COLLEEN (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:
Last Name:COMPERCHIO
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:COLLEEN
Other - Middle Name:
Other - Last Name:TERRELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10 ROXANNE RD
Mailing Address - Street 2:
Mailing Address - City:GROTON
Mailing Address - State:MA
Mailing Address - Zip Code:01450-1546
Mailing Address - Country:US
Mailing Address - Phone:719-369-8758
Mailing Address - Fax:
Practice Address - Street 1:14-16 FLETCHER ST STE 1
Practice Address - Street 2:
Practice Address - City:CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01824-2713
Practice Address - Country:US
Practice Address - Phone:978-212-9626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-09
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA78673235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist