Provider Demographics
NPI:1568895191
Name:PETERS, KERSTIN (MS)
Entity Type:Individual
Prefix:
First Name:KERSTIN
Middle Name:
Last Name:PETERS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:423 BLANEY RD
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:NH
Mailing Address - Zip Code:03574-4304
Mailing Address - Country:US
Mailing Address - Phone:603-616-5880
Mailing Address - Fax:
Practice Address - Street 1:423 BLANEY RD
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:NH
Practice Address - Zip Code:03574-4304
Practice Address - Country:US
Practice Address - Phone:603-616-5880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-19
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHP-0556235Z00000X
NH1565235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist