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General NPI Number Information
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NPI Number | 1659678597
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Entity Type | Organization
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Legal Business Name | AMY J. LISTER
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Dates
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Enumeration Date | 02/11/2011
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Last Update Date | 02/11/2011
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Provider Practice Location Address
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Address Line | 12 ADAMS AVE
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City | MERRIMACK
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State | NH
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Zip | 03054-7020
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Country | US
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Telephone | 603-566-4730
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Fax |
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Provider Business Mailing Address
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Address Line | 12 ADAMS AVE
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City | MERRIMACK
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State | NH
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Zip | 03054-7020
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Country | US
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Telephone | 603-566-4730
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Fax |
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Authorized Official
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Title or Position | SPEECH-LANGUAGE PATHOLOGIST
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Name | AMY J LISTER
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Credential | MS, CCC/SLP
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Telephone | 603-566-4730
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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 | 0939
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License Number State | NH
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