Linda Beach Bouffard, MS,CCC,SLP

Individual provider Active NPI Speech-Language Pathologist · Enfield, CT

NPI 1831439124 · NPPES record last updated Feb 22, 2013

Key facts

NPI
1831439124
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
001053 (CT)
Practice address
612 Hazard Ave
Enfield, CT 06082-4225
Phone
(860) 749-8388
NPI assigned
Feb 22, 2013
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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
001053CTMDSurgical Physician Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 001053 CT Yes

Addresses

Primary practice location

612 Hazard Ave
Enfield, CT 06082-4225

Mailing address

30 Sunrise Hill Dr
West Hartford, CT 06107-3348
Phone (860) 305-6613

Other providers in Enfield, CT

All providers in Enfield, CT · Speech-Language Pathologist in Connecticut

Sources for this page

Verify at the official NPI Registry.