Provider Demographics
NPI:1013122373
Name:SILVA, CULLEN DORIS (CCC SLP)
Entity Type:Individual
Prefix:MS
First Name:CULLEN
Middle Name:DORIS
Last Name:SILVA
Suffix:
Gender:F
Credentials:CCC SLP
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1020 SOMERSET AVE
Mailing Address - Street 2:UNIT #27
Mailing Address - City:NORTH DIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02764-1845
Mailing Address - Country:US
Mailing Address - Phone:508-669-5342
Mailing Address - Fax:508-669-5342
Practice Address - Street 1:977 MAIN ST
Practice Address - Street 2:COMMUNICATIVE HEALTH CARE ASSOCIATES
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02451-7406
Practice Address - Country:US
Practice Address - Phone:781-899-4709
Practice Address - Fax:781-899-4788
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6 208592235Z00000X
CA00666008235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0346195Medicaid