Provider Demographics
NPI:1659704997
Name:GILL, CLARE MARIE
Entity Type:Individual
Prefix:
First Name:CLARE
Middle Name:MARIE
Last Name:GILL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 WHITMAN RD
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MA
Mailing Address - Zip Code:02021-2707
Mailing Address - Country:US
Mailing Address - Phone:781-821-3499
Mailing Address - Fax:781-821-3905
Practice Address - Street 1:1 WHITMAN RD
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MA
Practice Address - Zip Code:02021-2707
Practice Address - Country:US
Practice Address - Phone:781-821-3499
Practice Address - Fax:781-821-3905
Is Sole Proprietor?:No
Enumeration Date:2013-08-09
Last Update Date:2013-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA457728235500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235500000XSpeech, Language and Hearing Service ProvidersSpecialist/Technologist