MEDICARE: MS. JEANNE HUGHES O'SULLIVAN CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	440	NH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194895409
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JEANNE HUGHES O'SULLIVAN CCC-SLP

Provider Business Mailing Address
First Line	:	4 LIBRARY WAY
Second Line	:	185 HEWITT HALL
City	:	DURHAM
State	:	NH
Zip	:	03824-3520
Country	:	US
Telephone Number	:	603-862-0055
Fax Number	:	603-862-4511

Provider Business Practice Location Address
First Line	:	4 LIBRARY WAY
Second Line	:	185 HEWITT HALL
City	:	DURHAM
State	:	NH
Zip	:	03824-3520
Country	:	US
Telephone Number	:	603-862-0055
Fax Number	:	603-862-4511

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2006
Last Update Date	:	07/09/2007

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