Provider Demographics
NPI:1528419892
Name:LINEHAM, MOLLY E (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MOLLY
Middle Name:E
Last Name:LINEHAM
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:MS
Other - First Name:MOLLY
Other - Middle Name:E
Other - Last Name:MULCAHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:2 FORDS LANDING DR
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-4552
Mailing Address - Country:US
Mailing Address - Phone:603-833-5589
Mailing Address - Fax:
Practice Address - Street 1:87 LAFAYETTE RD STE 3
Practice Address - Street 2:
Practice Address - City:HAMPTON FALLS
Practice Address - State:NH
Practice Address - Zip Code:03844
Practice Address - Country:US
Practice Address - Phone:603-926-3277
Practice Address - Fax:888-519-7585
Is Sole Proprietor?:No
Enumeration Date:2016-06-28
Last Update Date:2019-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NH1725235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program