Provider Demographics
NPI:1578640595
Name:SIMONCELLI, TRISHA ANN (MA, CCC/SLP)
Entity Type:Individual
Prefix:MS
First Name:TRISHA
Middle Name:ANN
Last Name:SIMONCELLI
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 1:17 COCASSET ST
Mailing Address - Street 2:
Mailing Address - City:FOXBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02035-2948
Mailing Address - Country:US
Mailing Address - Phone:508-698-3709
Mailing Address - Fax:508-698-3785
Practice Address - Street 1:17 COCASSET ST
Practice Address - Street 2:
Practice Address - City:FOXBORO
Practice Address - State:MA
Practice Address - Zip Code:02035-2948
Practice Address - Country:US
Practice Address - Phone:508-698-3709
Practice Address - Fax:508-698-3785
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7489235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist