Provider Demographics
NPI:1790239721
Name:MCINERNEY, CATHLEEN
Entity Type:Individual
Prefix:
First Name:CATHLEEN
Middle Name:
Last Name:MCINERNEY
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 1:8 HENSHAW ST STE F
Mailing Address - Street 2:
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801-4679
Mailing Address - Country:US
Mailing Address - Phone:781-935-3855
Mailing Address - Fax:781-935-5250
Practice Address - Street 1:8 HENSHAW ST STE F
Practice Address - Street 2:
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-4679
Practice Address - Country:US
Practice Address - Phone:781-935-3855
Practice Address - Fax:781-935-5250
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-08
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1758235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist