Provider Demographics
NPI:1245355403
Name:NEVILLE, MARY E (SLP)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:E
Last Name:NEVILLE
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 ISABELLA DR
Mailing Address - Street 2:
Mailing Address - City:LONDONDERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03053-3044
Mailing Address - Country:US
Mailing Address - Phone:603-437-6678
Mailing Address - Fax:603-437-6678
Practice Address - Street 1:80 NASHUA RD
Practice Address - Street 2:BLDG B, UNIT 4
Practice Address - City:LONDONDERRY
Practice Address - State:NH
Practice Address - Zip Code:03053-0305
Practice Address - Country:US
Practice Address - Phone:603-818-4448
Practice Address - Fax:603-818-8704
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0467235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist