Individual
SHELLEY JAN WEISS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
815 CENTRE ST, #5, JAMAICA PLAIN, MA 02130-2735
(617) 983-1999
Mailing address
815 CENTRE ST, #5, JAMAICA PLAIN, MA 02130-2735
(617) 983-1999
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3755
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
73710076
PROVIDER # BCBS
MA
Enumeration date
01/23/2007
Last updated
07/08/2007
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