Provider Demographics
NPI:1881133361
Name:LEDUC, KATIE MAUREEN
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:MAUREEN
Last Name:LEDUC
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 1:16 RIDGECREST DR
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NH
Mailing Address - Zip Code:03051-5027
Mailing Address - Country:US
Mailing Address - Phone:978-888-8151
Mailing Address - Fax:
Practice Address - Street 1:40 CROSBY ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:NH
Practice Address - Zip Code:03055-4707
Practice Address - Country:US
Practice Address - Phone:603-673-7061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-17
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1715235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist