Provider Demographics
NPI:1033882378
Name:DENONCOUR, WANDA MOULTON (SLP)
Entity Type:Individual
Prefix:MS
First Name:WANDA
Middle Name:MOULTON
Last Name:DENONCOUR
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-2934
Mailing Address - Country:US
Mailing Address - Phone:603-225-0853
Mailing Address - Fax:
Practice Address - Street 1:40 SEWALLS FALLS RD
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-4649
Practice Address - Country:US
Practice Address - Phone:603-225-0853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-30
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0175235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist