Individual
STACEY GLEASON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
25 UNIVERSITY RD, BROOKLINE, MA 02445-4532
(617) 383-4943
Mailing address
25 UNIVERSITY RD, BROOKLINE, MA 02445-4532
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
6869
MA
Other
Enumeration date
03/23/2015
Last updated
03/23/2015
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