Individual
MS. ELLEN HATHAWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
411 WAVERLY OAKS RD, BUILDING #3,SUITE 305, WALTHAM, MA 02452-8448
(781) 894-6564
(781) 893-5938
Mailing address
411 WAVERLY OAKS RD, BUILDING #3,SUITE 305, WALTHAM, MA 02452-8448
(781) 894-6564
(781) 893-5938
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP 3498-SL
MA
Other
Enumeration date
11/13/2007
Last updated
11/13/2007
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