Organization
WELLESLEY PEDIATRIC SPEECH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IVY KUBLIN (SOLE MBR)
(781) 489-3697
Entity
Organization
Contact information
Practice address
65 WALNUT ST, SUITE 302, WELLESLEY, MA 02481-2118
(781) 489-3697
Mailing address
65 WALNUT ST, SUITE 302, WELLESLEY, MA 02481-2118
(781) 489-3697
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7659
MA
Other
Enumeration date
08/12/2010
Last updated
09/07/2012
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