Individual
MAXWELL ELIOT KON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S., CCC-SLP
Contact information
Practice address
484 MAIN ST, EASTER SEALS MASSACHUSETTS, WORCESTER, MA 01608-1893
(800) 244-2756
Mailing address
484 MAIN ST, EASTER SEALS MASSACHUSETTS, WORCESTER, MA 01608-1893
(800) 244-2756
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
SP-9896-SL
MA
Other
Enumeration date
07/25/2013
Last updated
06/02/2016
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