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Individual

MARY SHAIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
SLP

Contact information

Practice address
28 SHAKER RD, NEW LONDON, NH 03257-5954
(603) 526-2940
(603) 526-2940
Mailing address
28 SHAKER RD, NEW LONDON, NH 03257-5954
(603) 526-2940
(603) 526-2940

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
0288
NH
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
30761482
NH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
30400646
NH
05
30761482
NH
Enumeration date
05/24/2007
Last updated
06/25/2008
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