Provider Demographics
NPI:1831320696
Name:MCCONNELL, MARTHA A (MS-CCC SLP)
Entity Type:Individual
Prefix:MRS
First Name:MARTHA
Middle Name:A
Last Name:MCCONNELL
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 1:206 TALL OAKS DR
Mailing Address - Street 2:UNIT P
Mailing Address - City:WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02190-3559
Mailing Address - Country:US
Mailing Address - Phone:978-317-2465
Mailing Address - Fax:
Practice Address - Street 1:206 TALL OAKS DR
Practice Address - Street 2:UNIT P
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190-3559
Practice Address - Country:US
Practice Address - Phone:978-317-2465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-28
Last Update Date:2014-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7745235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist