Doctor Name: | MS. ANNIE DIVELLO |
NPI Number: | 1518197482 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 1171 |
Business Practice Address: | 21 Searles Rd Windham, NH - 030871203 |
Business Phone Number: | 6038901290 |
Business Fax Number: | |
Mailing Address: | 35 Eagle Nest Way, MANCHESTER |
State: | NH |
Postal Code: | 031046416 |
Phone Number: | 6038365246 |
Fax Number: | |
NPI Enumeration Date: | 07/24/2009 |
NPI Last Update Date: | 07/24/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 1171 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NH |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |