Individual
MS. LAURA MARIE THEOBALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP
Contact information
Practice address
346 SAGAMORE RD, RYE, NH 03870-2035
(207) 590-9194
Mailing address
346 SAGAMORE RD, RYE, NH 03870-2035
(207) 590-9194
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
0649
NH
235Z00000X
Speech-Language Pathologist
7656
MA
235Z00000X
Speech-Language Pathologist
SP1066
ME
Other
Enumeration date
09/21/2012
Last updated
09/21/2012
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