Provider Demographics
NPI:1023693355
Name:TREMBLY, BETTY (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:BETTY
Middle Name:
Last Name:TREMBLY
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 1:76 WRIGHT ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02474-1377
Mailing Address - Country:US
Mailing Address - Phone:617-955-7638
Mailing Address - Fax:
Practice Address - Street 1:3 HARVEST CIR
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:MA
Practice Address - Zip Code:01773-3213
Practice Address - Country:US
Practice Address - Phone:781-388-5985
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-18
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3068235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist