Basic Information
| Provider Information | |||||||||
| NPI: | 1013238195 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GROVER | ||||||||
| FirstName: | MARY | ||||||||
| MiddleName: | E. | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.S. CCC-SLP | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | CORRADI | ||||||||
| OtherFirstName: | MARY | ||||||||
| OtherMiddleName: | |||||||||
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| OtherCredential: | M.S. CCC-SLP | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 84 EARLES WAY | ||||||||
| Address2: | |||||||||
| City: | CHATHAM | ||||||||
| State: | MA | ||||||||
| PostalCode: | 026331703 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | |||||||||
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| Practice Location | |||||||||
| Address1: | 390 ORLEANS RD | ||||||||
| Address2: | |||||||||
| City: | NORTH CHATHAM | ||||||||
| State: | MA | ||||||||
| PostalCode: | 026501154 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5089459611 | ||||||||
| FaxNumber: | 5089459603 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/12/2010 | ||||||||
| LastUpdateDate: | 02/10/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 8124 | MA | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.