Provider Demographics
NPI:1477918068
Name:SIMKEVICH, THERESA
Entity type:Individual
Prefix:MRS
First Name:THERESA
Middle Name:
Last Name:SIMKEVICH
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 1:21 HAMPTON RD
Mailing Address - Street 2:STE. 103
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-4831
Mailing Address - Country:US
Mailing Address - Phone:603-778-1780
Mailing Address - Fax:866-863-2967
Practice Address - Street 1:21 HAMPTON RD
Practice Address - Street 2:STE. 103
Practice Address - City:EXETER
Practice Address - State:NH
Practice Address - Zip Code:03833-4831
Practice Address - Country:US
Practice Address - Phone:603-778-1780
Practice Address - Fax:866-863-2967
Is Sole Proprietor?:No
Enumeration Date:2015-12-23
Last Update Date:2015-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHH652237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist