Provider Demographics
NPI:1366568578
Name:WALENCIS, CATHERINE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:WALENCIS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:
Other - Last Name:HAINSWORTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:29 BIRCHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03055-8933
Mailing Address - Country:US
Mailing Address - Phone:603-809-3380
Mailing Address - Fax:
Practice Address - Street 1:29 BIRCHWOOD DR
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:NH
Practice Address - Zip Code:03055-8933
Practice Address - Country:US
Practice Address - Phone:603-809-3380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5446235Z00000X
VA2202004620235Z00000X
NH1091235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist