Provider Demographics
NPI:1801065917
Name:SPIEWAK, SANDRA CONNIE (MS CCC SLP)
Entity type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:CONNIE
Last Name:SPIEWAK
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 1:20 CAPTAIN MAC ST
Mailing Address - Street 2:
Mailing Address - City:CHICOPEE
Mailing Address - State:MA
Mailing Address - Zip Code:01013-2516
Mailing Address - Country:US
Mailing Address - Phone:413-219-4458
Mailing Address - Fax:
Practice Address - Street 1:1 ROUNDHOUSE PLZ STE 203
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-4430
Practice Address - Country:US
Practice Address - Phone:413-586-1945
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-22
Last Update Date:2008-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3244235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist