Doctor Name: | MRS. ELIZABETH JANE O'CONNOR |
NPI Number: | 1720032352 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A. |
License Number: | SP00046 |
Business Practice Address: | 830 Chalkstone Ave Providence, RI - 029084734 |
Business Phone Number: | 4012737100 |
Business Fax Number: | 4015252529 |
Mailing Address: | 64 Forest St, PROVIDENCE |
State: | RI |
Postal Code: | 029062628 |
Phone Number: | 4014212758 |
Fax Number: | |
NPI Enumeration Date: | 05/19/2006 |
NPI Last Update Date: | 07/12/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SP00046 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | RI |
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 |