Healthcare Provider Details

I. General information

NPI: 1710013800
Provider Name (Legal Business Name): KAREN DALE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 07/30/2020
Certification Date: 07/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

194 PLEASANT ST STE 2
CONCORD NH
03301-2915
US

IV. Provider business mailing address

117 RAILROAD ST
KEENE NH
03431-3747
US

V. Phone/Fax

Practice location:
  • Phone: 603-354-6673
  • Fax: 603-357-9267
Mailing address:
  • Phone: 603-354-6673
  • Fax: 603-357-9267

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberA556
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: