Individual
MRS. LINDA WRINN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA CCC-SLP
Contact information
Practice address
50 BENNETT ST S, GLOUCESTER, MA 01930-1356
(617) 417-3575
Mailing address
50 BENNETT ST S, GLOUCESTER, MA 01930-1356
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4062
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0305090
MASSHEALTH
MA
Enumeration date
04/05/2016
Last updated
04/05/2016
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