Provider Demographics
NPI:1861712606
Name:ESSENCY, NADINE GAIL (MS/SLP)
Entity type:Individual
Prefix:MS
First Name:NADINE
Middle Name:GAIL
Last Name:ESSENCY
Suffix:
Gender:F
Credentials:MS/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:HARWICH
Mailing Address - State:MA
Mailing Address - Zip Code:02645-1670
Mailing Address - Country:US
Mailing Address - Phone:203-206-7433
Mailing Address - Fax:
Practice Address - Street 1:25 BELMONT AVE
Practice Address - Street 2:
Practice Address - City:HARWICH
Practice Address - State:MA
Practice Address - Zip Code:02645-1670
Practice Address - Country:US
Practice Address - Phone:203-206-7433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-03
Last Update Date:2010-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7860235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist