Provider Demographics
NPI:1164533931
Name:HECKMAN, MAUREEN W (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:W
Last Name:HECKMAN
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:628 RESERVOIR DR
Mailing Address - Street 2:
Mailing Address - City:WEARE
Mailing Address - State:NH
Mailing Address - Zip Code:03281-4008
Mailing Address - Country:US
Mailing Address - Phone:603-529-7798
Mailing Address - Fax:
Practice Address - Street 1:525 CLINTON ST
Practice Address - Street 2:
Practice Address - City:BOW
Practice Address - State:NH
Practice Address - Zip Code:03304-4609
Practice Address - Country:US
Practice Address - Phone:603-225-4153
Practice Address - Fax:603-226-3354
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0020235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30042YMedicare UPIN