Healthcare Provider Details

I. General information

NPI: 1588293930
Provider Name (Legal Business Name): ALISON WICHROSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2020
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 MCMANUS RD
WOLFEBORO NH
03894-4467
US

IV. Provider business mailing address

22 ROLLER COASTER RD
STRAFFORD NH
03884-6648
US

V. Phone/Fax

Practice location:
  • Phone: 603-569-0224
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number09128055
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number0837
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: