Judith G Harisiades, SLP

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

NPI 1669093522 · NPPES record last updated May 1, 2020

Key facts

NPI
1669093522
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
0185 (NH)
Practice address
209 Academy Rd
Pembroke, NH 03275-1343
Phone
(603) 485-7881
NPI assigned
May 1, 2020
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 0185 NH Yes

Addresses

Primary practice location

209 Academy Rd
Pembroke, NH 03275-1343

Mailing address

25 Farrwood Dr
Hooksett, NH 03106-2127
Phone (603) 361-0138

Other providers in Pembroke, NH

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

Sources for this page

Verify at the official NPI Registry.