Provider Demographics
NPI:1235346917
Name:GONRING, FAITH MARY (MS CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:FAITH
Middle Name:MARY
Last Name:GONRING
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:FAITH
Other - Middle Name:MARY
Other - Last Name:GONRING
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:244 HIGHWATCH RD
Mailing Address - Street 2:
Mailing Address - City:EFFINGHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03882
Mailing Address - Country:US
Mailing Address - Phone:800-473-4221
Mailing Address - Fax:603-539-8888
Practice Address - Street 1:244 HIGHWATCH RD
Practice Address - Street 2:
Practice Address - City:EFFINGHAM
Practice Address - State:NH
Practice Address - Zip Code:03882
Practice Address - Country:US
Practice Address - Phone:800-473-4221
Practice Address - Fax:603-539-8888
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MESP1063235Z00000X
NH1155235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME037658OtherANTHEM
ME037658OtherANTHEM