Healthcare Provider Details

I. General information

NPI: 1649458852
Provider Name (Legal Business Name): TOBY FREEMAN, M.S., C.C.C.,-SP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2008
Last Update Date: 05/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 GALLOWAY LN
BEDFORD NH
03110-5718
US

IV. Provider business mailing address

24 GALLOWAY LN
BEDFORD NH
03110-5718
US

V. Phone/Fax

Practice location:
  • Phone: 603-472-3144
  • Fax: 603-471-0041
Mailing address:
  • Phone: 603-472-3144
  • Fax: 603-471-0041

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number0018
License Number StateNH

VIII. Authorized Official

Name: TOBY ELLEN FREEMAN
Title or Position: DIRECTOR
Credential: MS, C.C.C.-SP.
Phone: 603-472-3144