Provider Demographics
NPI:1417048869
Name:UNIVERSITY SYSTEM OF NEW HAMPSHIRE
Entity Type:Organization
Organization Name:UNIVERSITY SYSTEM OF NEW HAMPSHIRE
Other - Org Name:UNH SPEECH-LANGUAGE-HEARING CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:SENIOR CONTRACT OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:JONES
Authorized Official - Last Name:COTTER
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:603-862-0951
Mailing Address - Street 1:18 GARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03824-2334
Mailing Address - Country:US
Mailing Address - Phone:603-862-0352
Mailing Address - Fax:
Practice Address - Street 1:4 LIBRARY WAY
Practice Address - Street 2:183 HEWITT HALL
Practice Address - City:DURHAM
Practice Address - State:NH
Practice Address - Zip Code:03824-3520
Practice Address - Country:US
Practice Address - Phone:603-862-2901
Practice Address - Fax:603-862-4511
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIVERSITY SYSTEM OF NEW HAMPSHIRE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-28
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH02600937261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH=========OtherTAX ID NUMBER