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General NPI Number Information
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NPI Number | 1538534433
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Entity Type | Organization
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Legal Business Name | UPPER VALLEY SPEECH-LANGUAGE SERVICES
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Dates
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Enumeration Date | 12/03/2015
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Last Update Date | 12/03/2015
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Provider Practice Location Address
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Address Line | 1 COURT ST SUITE 360
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City | LEBANON
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State | NH
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Zip | 03766-1358
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Country | US
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Telephone | 603-448-5218
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Fax | 603-448-5219
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Provider Business Mailing Address
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Address Line | 1 COURT ST SUITE 360
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City | LEBANON
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State | NH
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Zip | 03766-1358
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Country | US
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Telephone | 603-448-5218
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Fax | 603-448-5219
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Authorized Official
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Title or Position | SPEECH-LANGUAGE PATHOLOGIST
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Name | MRS. DENISE MARIE MITCHELL
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Credential | SL-P
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Telephone | 603-448-5218
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 0210
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License Number State | NH
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