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General NPI Number Information
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NPI Number | 1720494388
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Entity Type | Organization
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Legal Business Name | NEW ENGLAND INSTITUTE OF DEVELOPMENTAL PEDIATRICS
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Dates
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Enumeration Date | 07/03/2014
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Last Update Date | 07/03/2014
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Provider Practice Location Address
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Address Line | 26 SHAKER RD
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City | CONCORD
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State | NH
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Zip | 03301-6924
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Country | US
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Telephone | 603-715-2298
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Fax |
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Provider Business Mailing Address
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Address Line | 26 SHAKER RD
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City | CONCORD
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State | NH
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Zip | 03301-6924
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Country | US
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Telephone | 603-715-2298
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | ADRIENNE FERRO EVANS
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Credential |
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Telephone | 603-715-2298
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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