Provider Demographics
NPI:1750001137
Name:GUILLEMETTE, TESSA (CCC-SLP)
Entity type:Individual
Prefix:
First Name:TESSA
Middle Name:
Last Name:GUILLEMETTE
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 MARSTON WAY
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:NH
Mailing Address - Zip Code:03842-2055
Mailing Address - Country:US
Mailing Address - Phone:603-926-8708
Mailing Address - Fax:
Practice Address - Street 1:4 MARSTON WAY
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:NH
Practice Address - Zip Code:03842-2055
Practice Address - Country:US
Practice Address - Phone:603-926-8708
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2243235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist