Healthcare Provider Details
I. General information
NPI: 1609267665
Provider Name (Legal Business Name): HAMPSHIRE HEARING AND SPEECH SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/12/2015
Last Update Date: 02/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
241 KING ST #119
NORTHAMPTON MA
01060-2335
US
IV. Provider business mailing address
241 KING ST #119
NORTHAMPTON MA
01060-2335
US
V. Phone/Fax
- Phone: 413-586-9572
- Fax:
- Phone: 413-586-9572
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 231H00000X |
| Taxonomy | Audiologist |
| License Number | 486 |
| License Number State | MA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | 3388 |
| License Number State | MA |
VIII. Authorized Official
Name: MRS.
ALLISON
COLLEEN
HOLMBERG
Title or Position: OWNER-AUDIOLOGIST/SLP
Credential: M.S., CCC- A/SLP
Phone: 413-586-9572