Provider Demographics
NPI:1982772646
Name:MCCARTHY, MICHELLE PATRICE (MS, CCC-SLP, CEIS)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:PATRICE
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:MS, CCC-SLP, CEIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 3RD ST
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062-4857
Mailing Address - Country:US
Mailing Address - Phone:781-769-7443
Mailing Address - Fax:
Practice Address - Street 1:198 VANDERBILT AVE
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-5025
Practice Address - Country:US
Practice Address - Phone:781-551-0405
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5705235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist