Provider Demographics
NPI:1912167016
Name:MORIARTY, PATRICIA LYONS (MA, CCC, SLP)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:LYONS
Last Name:MORIARTY
Suffix:
Gender:F
Credentials:MA, CCC, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:191 WHITNEY ST
Mailing Address - Street 2:
Mailing Address - City:NORTHBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01532-1452
Mailing Address - Country:US
Mailing Address - Phone:508-393-6632
Mailing Address - Fax:
Practice Address - Street 1:191 WHITNEY ST
Practice Address - Street 2:
Practice Address - City:NORTHBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01532-1452
Practice Address - Country:US
Practice Address - Phone:508-393-6632
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-11
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5267235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist