Individual
STACEY EDGAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLS
Contact information
Practice address
112 RESERVOIR AVE, MANCHESTER, NH 03104-4468
(603) 624-6352
Mailing address
20 HECKER ST, MANCHESTER, NH 03102-3975
(603) 624-3600
Taxonomy
Speciality
Code
Description
License number
State
235500000X
Speech/Language/Hearing Specialist/Technologist
Primary
71891
NH
Other
Enumeration date
05/14/2020
Last updated
05/14/2020
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