Provider Demographics
NPI:1558871616
Name:CLEMENTS, NANCY (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:CLEMENTS
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 NORTH RD STE 3100
Mailing Address - Street 2:
Mailing Address - City:SUDBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01776-1182
Mailing Address - Country:US
Mailing Address - Phone:978-610-6603
Mailing Address - Fax:
Practice Address - Street 1:144 NORTH RD STE 3100
Practice Address - Street 2:
Practice Address - City:SUDBURY
Practice Address - State:MA
Practice Address - Zip Code:01776-1182
Practice Address - Country:US
Practice Address - Phone:978-610-6603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-03
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MASLP8632235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist