Laura Marie Theobald, MS CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Rye, NH

NPI 1033460746 · NPPES record last updated Sep 21, 2012

Key facts

NPI
1033460746
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
0649 (NH)
Practice address
346 Sagamore Rd
Rye, NH 03870-2035
Phone
(207) 590-9194
NPI assigned
Sep 21, 2012
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
7656MAMDFamily Psychologist
SP1066MEMDSpeech-Language Pathologist
0649NHMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Laura Theobald Speech Therapy, LLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 0649 NH Yes
Speech-Language Pathologist 235Z00000X 7656 MA
Speech-Language Pathologist 235Z00000X SP1066 ME

Addresses

Primary practice location

346 Sagamore Rd
Rye, NH 03870-2035

Mailing address

346 Sagamore Rd
Rye, NH 03870-2035
Phone (207) 590-9194

Other providers in Rye, NH

All providers in Rye, NH · Speech-Language Pathologist in New Hampshire

Sources for this page

Verify at the official NPI Registry.