Provider Demographics
NPI:1235455106
Name:REGGIO, MARIE FRANCES
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:FRANCES
Last Name:REGGIO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 POLLARD DR
Mailing Address - Street 2:
Mailing Address - City:MILLIS
Mailing Address - State:MA
Mailing Address - Zip Code:02054-1225
Mailing Address - Country:US
Mailing Address - Phone:508-376-5739
Mailing Address - Fax:
Practice Address - Street 1:17 POLLARD DR
Practice Address - Street 2:
Practice Address - City:MILLIS
Practice Address - State:MA
Practice Address - Zip Code:02054-1225
Practice Address - Country:US
Practice Address - Phone:508-376-5739
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-16
Last Update Date:2010-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3638235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist