Healthcare Provider Details

I. General information

NPI: 1336688522
Provider Name (Legal Business Name): MRS. HEATHER BAYBUTT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2017
Last Update Date: 03/18/2022
Certification Date: 03/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 SCHOOL ST
MERRIMACK NH
03054-3684
US

IV. Provider business mailing address

806 N MAIN ST
LACONIA NH
03246-2603
US

V. Phone/Fax

Practice location:
  • Phone: 603-424-6218
  • Fax:
Mailing address:
  • Phone: 603-524-9090
  • Fax: 603-524-1497

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number1721
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: