Kirstin Bradshaw, MA, CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Sandwich, MA

NPI 1942615554 · NPPES record last updated Jan 25, 2016

Key facts

NPI
1942615554
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
9676 (MA)
Practice address
280 D Route 130
Suite 7 Heritage Park Plaza
Sandwich, MA 02563-2363
Phone
(509) 833-1060
NPI assigned
Jun 23, 2014
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 Arts

State licenses

LicenseStateTypeSpecialty
9676MAMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 9676 MA Yes

Addresses

Primary practice location

280 D Route 130
Suite 7 Heritage Park Plaza
Sandwich, MA 02563-2363

Mailing address

280 D Route 130
Suite 7 Heritage Park Plaza
Sandwich, MA 02563-2363
Phone (509) 833-1060

Other providers in Sandwich, MA

All providers in Sandwich, MA · Speech-Language Pathologist in Massachusetts

Sources for this page

Verify at the official NPI Registry.