Provider Demographics
NPI:1750075909
Name:TSOUMAS MCDONOUGH, DEMETRA (CCC-SLP)
Entity type:Individual
Prefix:
First Name:DEMETRA
Middle Name:
Last Name:TSOUMAS MCDONOUGH
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 IROQUOIS RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02476-7841
Mailing Address - Country:US
Mailing Address - Phone:781-859-9127
Mailing Address - Fax:
Practice Address - Street 1:58 IROQUOIS RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02476-7841
Practice Address - Country:US
Practice Address - Phone:781-648-2245
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-08
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist