| Doctor Name: | MS. JEANINE LEA MINDRUM |
| NPI Number: | 1194933085 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA-CCC-SLP |
| License Number: | 2743 |
| Business Practice Address: | 214 Lake St Child Development Center Shrewsbury, MA - 015453960 |
| Business Phone Number: | 5088564202 |
| Business Fax Number: | 5088452783 |
| Mailing Address: | 24 Ruggles St, #2 WESTBOROUGH |
| State: | MA |
| Postal Code: | 015812036 |
| Phone Number: | 5083661190 |
| Fax Number: | 5088452783 |
| NPI Enumeration Date: | 05/21/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 2743 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |