Provider Demographics
NPI:1174779201
Name:HOROWITZ, EVA BEATRICE (MS)
Entity type:Individual
Prefix:MRS
First Name:EVA
Middle Name:BEATRICE
Last Name:HOROWITZ
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 BONAIRE CIR
Mailing Address - Street 2:
Mailing Address - City:WABAN
Mailing Address - State:MA
Mailing Address - Zip Code:02468-1404
Mailing Address - Country:US
Mailing Address - Phone:617-965-0452
Mailing Address - Fax:617-558-5494
Practice Address - Street 1:11 BONAIRE CIRCLE
Practice Address - Street 2:
Practice Address - City:WABAN
Practice Address - State:MA
Practice Address - Zip Code:02468-1404
Practice Address - Country:US
Practice Address - Phone:617-965-0452
Practice Address - Fax:617-558-5494
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-08
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA680235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist