Provider Demographics
NPI:1942336151
Name:BEHL, MARY T
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:T
Last Name:BEHL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 EASTWOOD RD
Mailing Address - Street 2:
Mailing Address - City:WINDHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03087-1638
Mailing Address - Country:US
Mailing Address - Phone:603-432-5969
Mailing Address - Fax:
Practice Address - Street 1:44 PARK ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01810-3692
Practice Address - Country:US
Practice Address - Phone:978-247-8933
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-24
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3223235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist