Individual
KATHRYN TERESA IVEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
9 EXECUTIVE PARK DR, SUITE 100, MERRIMACK, NH 03054-4045
(603) 424-1950
(603) 424-4749
Mailing address
9 EXECUTIVE PARK DR, SUITE 100, MERRIMACK, NH 03054-4045
(603) 424-1950
(603) 424-4749
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
0084
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30005180
MEDICAID NH
NH
Enumeration date
12/11/2006
Last updated
02/16/2012
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