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Individual

MS. EMILIE ROSE LOWELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.S., CCC-SLP

Contact information

Practice address
940 BELMONT ST BLDG 3, BROCKTON, MA 02301-5596
(774) 826-2133
Mailing address
3957 WASHINGTON ST APT 3L, ROSLINDALE, MA 02131-1240
(508) 505-8031

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
76492
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
14134184
ASHA CERTIFICATION OF CLINICAL COMPETENCE
MA
01
76492
MASSACHUSETTS STATE LICENSURE IN SPEECH LANGUAGE PATHOLOGY
MA
Enumeration date
07/24/2017
Last updated
07/24/2017
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