Doctor Name: | EILEEN CONNOLLY |
NPI Number: | 1558502088 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S. CCC-SLP |
License Number: | 8425 |
Business Practice Address: | 28 Zamora St Apt 1 Jamaica Plain, MA - 021301710 |
Business Phone Number: | 5854551112 |
Business Fax Number: | |
Mailing Address: | 28 Zamora St, Apt 1 JAMAICA PLAIN |
State: | MA |
Postal Code: | 021301710 |
Phone Number: | 5854551112 |
Fax Number: | |
NPI Enumeration Date: | 03/12/2009 |
NPI Last Update Date: | 02/09/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 8425 |
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 |