Ivy Marie Boggs, MS/CCC-SLP

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

NPI 1669093605 · NPPES record last updated Sep 21, 2020

Key facts

NPI
1669093605
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
0115 (NH)
Practice address
317 Main St
Somersworth, NH 03878-3099
Phone
(603) 692-4411
Fax
(603) 692-6717
NPI assigned
Apr 30, 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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
0115NHMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 0115 NH Yes

Addresses

Primary practice location

317 Main St
Somersworth, NH 03878-3099

Mailing address

11 Hodgkins Way
Rochester, NH 03868-5911
Phone (603) 335-6286

Other practice location 1

31A W Main St
Newton, NH 03858-3532
Phone (603) 679-2021

Other names

  • Ivy Marie Boggis Gooden Former name

Other providers in Somersworth, NH

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

Sources for this page

Verify at the official NPI Registry.