Provider Demographics
NPI:1780820514
Name:IVINS, MARGEAUX (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MARGEAUX
Middle Name:
Last Name:IVINS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 ROLLING MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:HOLLISTON
Mailing Address - State:MA
Mailing Address - Zip Code:01746-2630
Mailing Address - Country:US
Mailing Address - Phone:860-539-6274
Mailing Address - Fax:
Practice Address - Street 1:40 ROLLING MEADOW DR
Practice Address - Street 2:
Practice Address - City:HOLLISTON
Practice Address - State:MA
Practice Address - Zip Code:01746-2630
Practice Address - Country:US
Practice Address - Phone:860-539-6274
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-29
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist