Madeline Pennebaker
Speech-Language Pathologist, in Somerville, MA. Individual provider (NPI-1).
NPI number1164035630
StatusActive
Last updated in NPPESAug 25, 2020
Details
- NPI
- 1164035630
- Entity type
- Individual (NPI-1)
- Name
- Madeline Pennebaker
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Aug 25, 2020
- Certification date
- Aug 25, 2020
- Last updated
- Aug 25, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 235Z00000X | Speech-Language Pathologist, | 77697 | MA | Yes |
Practice location
16 Buckingham St Apt 2Somerville, MA 02143-4313
Phone 617-475-0462
Mailing address
16 Buckingham St Apt 2Somerville, MA 02143-4313
Phone 713-498-6194
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All 49 Speech-Language Pathologist providers in Somerville · All 2,145 providers in Somerville
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