Provider Demographics
NPI:1295872646
Name:CRONIN, PATRICIA JOLENE (MS, CCC-A)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:JOLENE
Last Name:CRONIN
Suffix:
Gender:F
Credentials:MS, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 BIRCH ST
Mailing Address - Street 2:STE 304
Mailing Address - City:DERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03303
Mailing Address - Country:US
Mailing Address - Phone:603-432-8104
Mailing Address - Fax:603-434-2629
Practice Address - Street 1:44 BIRCH ST STE 304
Practice Address - Street 2:
Practice Address - City:DERRY
Practice Address - State:NH
Practice Address - Zip Code:03038-2752
Practice Address - Country:US
Practice Address - Phone:603-432-8104
Practice Address - Fax:603-434-2629
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHA336237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3073741Medicaid