Individual
DR. MARY ELLEN RANCOURT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AUD
Contact information
Practice address
43 MAIN ST, SOUTH GRAFTON, MA 01560-1132
(774) 293-1515
(774) 293-1315
Mailing address
43 MAIN ST, SOUTH GRAFTON, MA 01560-1132
(774) 293-1515
(774) 293-1315
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
469
MA
231H00000X
Audiologist
AUD00205
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050258937
TRICARE / HNF
RI
01
—
1972629459
BCBSRI
RI
01
—
2026;1140D
NHP RI
RI
05
—
5102634
—
MA
01
—
701262
TUFTS
MA
01
—
AD0014
BCBSMA
MA
Enumeration date
11/07/2005
Last updated
07/12/2022
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