Provider Demographics
NPI:1053729459
Name:FABRIZIO, CHARLEEN F (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:CHARLEEN
Middle Name:F
Last Name:FABRIZIO
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 ELIZABETH WAY
Mailing Address - Street 2:
Mailing Address - City:NORTH EASTON
Mailing Address - State:MA
Mailing Address - Zip Code:02356-2147
Mailing Address - Country:US
Mailing Address - Phone:781-589-4673
Mailing Address - Fax:
Practice Address - Street 1:28 ELIZABETH WAY
Practice Address - Street 2:
Practice Address - City:NORTH EASTON
Practice Address - State:MA
Practice Address - Zip Code:02356-2147
Practice Address - Country:US
Practice Address - Phone:781-589-4673
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-29
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6200235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist