Fedak, Larissa Ann
Fedak, Larissa Ann is an sole proprietor health care provider with primary practice located at 155 Main Dunstable Rd Ste 150 , Nashua NH 03060-3640. She recently has 2 registered licenses in different health care specialties including Speech, Language and Hearing Service Providers / Speech-Language Pathologist, Behavioral Health & Social Service Providers / Behavioral Analyst. Behavioral Health & Social Service Providers / Behavioral Analyst is her primary health care specialty. Fedak, Larissa Ann can be contacted via phone (603) 660-6306.Contact Information
Primary practice address
155 Main Dunstable Rd Ste 150
Nashua NH 03060-3640
Phone: (603) 660-6306
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | 41YS00572200 | New Jersey |
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | 018241 | New York |
| Behavioral Health & Social Service Providers / Behavioral Analyst | 103K00000X | 1-11-8515 |
Profile Details
| NPI number | 1235376997 |
|---|---|
| LBN Legal business name | Fedak, Larissa Ann |
| Credentials | EDD CCC-SLP BCBA-D |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 16th, 2009 |
| Last updated | Mar 16th, 2022 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1235376997 | NPPES |
| Other | 1-11-8515 | BCBA-D | |
| MEDICAID | 1235376997 | BCBA-D |
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