Individual
JACEY ZOE SHUMAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
77 WARREN ST, BUILDING 4, BRIGHTON, MA 02135-3601
(617) 930-1370
Mailing address
41 HARTFORD ST, NATICK, MA 01760-2402
(617) 930-1370
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4737
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SP0118
BCBS PROVIDER NUMBER
MA
Enumeration date
01/06/2007
Last updated
07/08/2007
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