Provider Demographics
NPI:1154506624
Name:SANTANA, NANCY ELISABETH (MS CCC-SLP CEIS)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:ELISABETH
Last Name:SANTANA
Suffix:
Gender:F
Credentials:MS CCC-SLP CEIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:149 SYLVAN ST
Mailing Address - Street 2:
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-3564
Mailing Address - Country:US
Mailing Address - Phone:978-774-7570
Mailing Address - Fax:978-777-8547
Practice Address - Street 1:149 SYLVAN ST
Practice Address - Street 2:
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-3564
Practice Address - Country:US
Practice Address - Phone:978-774-7570
Practice Address - Fax:978-777-8547
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-03
Last Update Date:2008-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5259235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist