Doctor Name: | KELLY A COUCCI |
NPI Number: | 1285709717 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CCC-SLP |
License Number: | 4517 |
Business Practice Address: | 299 Faunce Corner Road 2nd Floor North Dartmouth, MA - 02747 |
Business Phone Number: | 5089950700 |
Business Fax Number: | 5089953070 |
Mailing Address: | 200 Mill Rd, Suite 180 FAIRHAVEN |
State: | MA |
Postal Code: | 027195252 |
Phone Number: | 5089732000 |
Fax Number: | 5089732001 |
NPI Enumeration Date: | 11/21/2006 |
NPI Last Update Date: | 01/22/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 4517 |
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 |