Provider Demographics
NPI:1215176136
Name:O'SHEA, JANICE FREETHEY (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:FREETHEY
Last Name:O'SHEA
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 BURBANK RD
Mailing Address - Street 2:
Mailing Address - City:LONDONDERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03053-3172
Mailing Address - Country:US
Mailing Address - Phone:603-345-8710
Mailing Address - Fax:
Practice Address - Street 1:51 SHASTA DR
Practice Address - Street 2:
Practice Address - City:LONDONDERRY
Practice Address - State:NH
Practice Address - Zip Code:03053-3091
Practice Address - Country:US
Practice Address - Phone:603-548-2188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-17
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1102235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist