Doctor Name: | MRS. WENDELYN N CARRUTHERS |
NPI Number: | 1215112735 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS., CCC-SLP |
License Number: | 413579 |
Business Practice Address: | Thom Boston Metro Early Intervention 555 Amory Street Jamaica Plain, MA - 02130 |
Business Phone Number: | 6173834000 |
Business Fax Number: | |
Mailing Address: | 14 Ashton Street, Apt. 2 DORCHESTER |
State: | MA |
Postal Code: | 02124 |
Phone Number: | 6176358623 |
Fax Number: | 6176359947 |
NPI Enumeration Date: | 01/03/2008 |
NPI Last Update Date: | 01/03/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 413579 |
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 |