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Organization
MAGNIFICENT KIDS LLC
Active
Organization
MAGNIFICENT KIDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELISHA MAGNIFICO MA/CCC-SLP (MANAGER/SPEECH-LANGUAGE PATHOLOGIST)
(603) 924-7722
Entity
Organization
Contact information
Practice address
70 MAIN ST., SUITE 201, PETERBOROUGH, NH 03458-1238
(603) 924-7722
Mailing address
PO BOX 71, PETERBOROUGH, NH 03458-0071
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1111
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
272746
CIGNA
NH
05
—
3072607
—
NH
01
—
561822
AETNA
NH
01
—
626514
HARVARD PILGRIM
NH
01
—
66Y011091NH01
ANTHEM BCBS
NH
01
—
761242
TUFTS
NH
05
—
99560056
—
NH
Enumeration date
09/16/2009
Last updated
08/13/2013
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