Provider Demographics
NPI:1225151574
Name:MILATA, DEANNA (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:
Last Name:MILATA
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 LEAVITT RD
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:NH
Mailing Address - Zip Code:03044-3121
Mailing Address - Country:US
Mailing Address - Phone:603-300-2895
Mailing Address - Fax:
Practice Address - Street 1:300 HIGHLANDER WAY
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03101
Practice Address - Country:US
Practice Address - Phone:603-624-9002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0954235Z00000X
MA6444235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist