Healthcare Provider Details

I. General information

NPI: 1457090599
Provider Name (Legal Business Name): CHANTAL SIMARD AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2022
Last Update Date: 03/13/2025
Certification Date: 03/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

158 NH ROUTE 108 STE G
DOVER NH
03820-8812
US

IV. Provider business mailing address

2 CENTURY LN
LITCHFIELD NH
03052-1074
US

V. Phone/Fax

Practice location:
  • Phone: 603-742-6555
  • Fax: 603-742-3256
Mailing address:
  • Phone: 603-913-3424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number01608
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number01608
License Number StateMD
# 4
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberA854
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: