Provider Demographics
NPI:1750695490
Name:CENTRAL MASS SPEECH, LANGUAGE & BEHAVIOR SPECIALISTS, INC
Entity type:Organization
Organization Name:CENTRAL MASS SPEECH, LANGUAGE & BEHAVIOR SPECIALISTS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT/SPEECH PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:HIGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:508-523-2027
Mailing Address - Street 1:383 MOWER ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01602-1026
Mailing Address - Country:US
Mailing Address - Phone:508-523-2027
Mailing Address - Fax:508-459-1685
Practice Address - Street 1:383 MOWER ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01602-1026
Practice Address - Country:US
Practice Address - Phone:508-523-2027
Practice Address - Fax:508-459-1685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-05
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA12078116235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty