Healthcare Provider Details

I. General information

NPI: 1902446669
Provider Name (Legal Business Name): SEACOAST SPEAKS SPEECH AND LANGUAGE THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2020
Last Update Date: 01/10/2020
Certification Date: 01/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131B MAIN ST
EPPING NH
03042-2428
US

IV. Provider business mailing address

131B MAIN ST
EPPING NH
03042-2428
US

V. Phone/Fax

Practice location:
  • Phone: 603-734-5280
  • Fax: 603-734-5280
Mailing address:
  • Phone: 603-734-5280
  • Fax: 603-734-5280

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MS. EMILY BOOTH
Title or Position: SPEECH LANGUAGE PATHOLOGIST
Credential: MS, CCC-SLP
Phone: 781-223-5334