Provider Demographics
NPI:1578325064
Name:SCHAEFFER, NANCY MARIA (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:MARIA
Last Name:SCHAEFFER
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 1:51 MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06095-2603
Mailing Address - Country:US
Mailing Address - Phone:413-687-1218
Mailing Address - Fax:
Practice Address - Street 1:1111 ELM ST STE 17C
Practice Address - Street 2:
Practice Address - City:WEST SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01089-1540
Practice Address - Country:US
Practice Address - Phone:413-342-4027
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT006978235Z00000X
MASLP100916235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist