Provider Demographics
NPI:1538534433
Name:UPPER VALLEY SPEECH-LANGUAGE SERVICES
Entity type:Organization
Organization Name:UPPER VALLEY SPEECH-LANGUAGE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:SL-P
Authorized Official - Phone:603-448-5218
Mailing Address - Street 1:1 COURT ST
Mailing Address - Street 2:SUITE 360
Mailing Address - City:LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03766-1358
Mailing Address - Country:US
Mailing Address - Phone:603-448-5218
Mailing Address - Fax:603-448-5219
Practice Address - Street 1:1 COURT ST
Practice Address - Street 2:SUITE 360
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03766-1358
Practice Address - Country:US
Practice Address - Phone:603-448-5218
Practice Address - Fax:603-448-5219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-03
Last Update Date:2015-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0210235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty