Provider Demographics
NPI:1700046265
Name:PELLETIER, EMILY J (MS)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:J
Last Name:PELLETIER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:J
Other - Last Name:CONNORS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:32 BERNARD RD
Mailing Address - Street 2:
Mailing Address - City:STRAFFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03884-6875
Mailing Address - Country:US
Mailing Address - Phone:603-948-1953
Mailing Address - Fax:
Practice Address - Street 1:22 ROLLER COASTER RD
Practice Address - Street 2:
Practice Address - City:STRAFFORD
Practice Address - State:NH
Practice Address - Zip Code:03884-6648
Practice Address - Country:US
Practice Address - Phone:603-664-2842
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-09
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1230235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist