Susan Boelger, SLP

Individual provider Active NPI Speech-Language Pathologist · Johnston, RI

NPI 1033423967 · NPPES record last updated Aug 3, 2010

Key facts

NPI
1033423967
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
SP00141 (RI)
Practice address
1516 Atwood Ave
Johnston, RI 02919-3223
Phone
(401) 553-1000
Fax
(401) 553-1146
NPI assigned
Aug 3, 2010
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
SP00141RIMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP00141 RI Yes

Addresses

Primary practice location

1516 Atwood Ave
Johnston, RI 02919-3223

Mailing address

1516 Atwood Ave
Johnston, RI 02919-3223
Phone (401) 553-1000

Other identifiers

IdentifierTypeStateIssuer
050512037OtherRITHE AUTISM PROJECT

Other providers in Johnston, RI

All providers in Johnston, RI · Speech-Language Pathologist in Rhode Island

Sources for this page

Verify at the official NPI Registry.