Provider Demographics
NPI:1649399387
Name:ANNARUMA, EMILIA (MACCC-SLP)
Entity Type:Individual
Prefix:
First Name:EMILIA
Middle Name:
Last Name:ANNARUMA
Suffix:
Gender:F
Credentials:MACCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 366
Mailing Address - Street 2:
Mailing Address - City:WEST HARWICH
Mailing Address - State:MA
Mailing Address - Zip Code:02671-0366
Mailing Address - Country:US
Mailing Address - Phone:345-610-2891
Mailing Address - Fax:
Practice Address - Street 1:77 ROUTE 28
Practice Address - Street 2:
Practice Address - City:WEST HARWICH
Practice Address - State:MA
Practice Address - Zip Code:02671-1114
Practice Address - Country:US
Practice Address - Phone:345-610-2891
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist