Individual
MARIE CLAIRE CHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
1250 HANCOCK ST, QUINCY, MA 02169-4339
(617) 774-0600
(617) 774-0211
Mailing address
147 MILK ST, PROVIDER ENROLLMENT - 9TH FLOOR, BOSTON, MA 02109-4806
(617) 559-8053
(617) 421-3487
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
6923
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039869
NEIGHBORHOOD HEALTH
MA
01
—
908317
TUFTS
MA
Enumeration date
12/12/2006
Last updated
06/17/2011
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