Provider Demographics
NPI:1164750691
Name:HANRAHAN, LINDA LOUISE (SLP)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:LOUISE
Last Name:HANRAHAN
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:PO BOX 2123
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03302-2123
Mailing Address - Country:US
Mailing Address - Phone:603-267-5973
Mailing Address - Fax:603-267-1983
Practice Address - Street 1:124 HALL ST
Practice Address - Street 2:UNIT H
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-3478
Practice Address - Country:US
Practice Address - Phone:603-267-5973
Practice Address - Fax:603-267-1983
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-20
Last Update Date:2009-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0271235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30010671Medicaid