Provider Demographics
NPI:1285799577
Name:YORK, PATRICIA HELEN (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:HELEN
Last Name:YORK
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 1:13 LAMPREY RD
Mailing Address - Street 2:
Mailing Address - City:CANTERBURY
Mailing Address - State:NH
Mailing Address - Zip Code:03224-2215
Mailing Address - Country:US
Mailing Address - Phone:603-783-0326
Mailing Address - Fax:603-783-8388
Practice Address - Street 1:40 THORNTONS FERRY RD. #1
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NH
Practice Address - Zip Code:03031
Practice Address - Country:US
Practice Address - Phone:603-673-3345
Practice Address - Fax:603-673-4944
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0334235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH6603694Y0NH02OtherANTHEM PROVIDER NUMBER
NH22687YMedicare UPIN