Healthcare Provider Details

I. General information

NPI: 1093651002
Provider Name (Legal Business Name): MARINA FLETCHER LORD M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2026
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

92 COURT ST APT 2
EXETER NH
03833-2645
US

IV. Provider business mailing address

92 COURT ST APT 2
EXETER NH
03833-2645
US

V. Phone/Fax

Practice location:
  • Phone: 860-992-7468
  • Fax:
Mailing address:
  • Phone: 860-992-7468
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP4420
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number3332
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: