Provider Demographics
NPI:1316530405
Name:MUMPER, MEGAN DIANE (SPEECH PATHOLOGIST)
Entity type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:DIANE
Last Name:MUMPER
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Gender:F
Credentials:SPEECH PATHOLOGIST
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Mailing Address - Street 1:BOOTHBY THERAPY SERVICES
Mailing Address - Street 2:806 NORTH MAIN ST
Mailing Address - City:LACONIA
Mailing Address - State:NH
Mailing Address - Zip Code:03246
Mailing Address - Country:US
Mailing Address - Phone:603-524-9090
Mailing Address - Fax:603-524-1497
Practice Address - Street 1:209 ACADEMY RD
Practice Address - Street 2:
Practice Address - City:PEMBROKE
Practice Address - State:NH
Practice Address - Zip Code:03275-1345
Practice Address - Country:US
Practice Address - Phone:603-485-7881
Practice Address - Fax:603-485-1824
Is Sole Proprietor?:No
Enumeration Date:2021-02-19
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NHP-0802235Z00000X
NH2116235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist