Organization
SOUTH EAST CENTER FOR SWALLOWING & COMMUNICATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KATHLEEN LYNNE FITZGERALD MS CCC SLP (PRESIDENT)
(508) 991-2332
Entity
Organization
Contact information
Practice address
92 GRAPE ST, UNIT 1, NEW BEDFORD, MA 02740-2143
(508) 991-2332
(508) 991-8437
Mailing address
92 GRAPE ST, UNIT 1, NEW BEDFORD, MA 02740-2143
(508) 991-2332
(508) 991-8437
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
—
MA
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
691582
TUFTS HEALTH PLAN
MA
05
—
9737570
—
MA
01
—
AA14788
HARVARD PILGRIM
MA
01
—
OG0068
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS
MA
01
—
SG0002
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS
MA
Enumeration date
09/11/2006
Last updated
06/21/2018
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