Provider Demographics
NPI:1871366864
Name:SEMENOVA, OKSANA VIKTORIVNA
Entity type:Individual
Prefix:
First Name:OKSANA
Middle Name:VIKTORIVNA
Last Name:SEMENOVA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 TAYLOR LN
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-5754
Mailing Address - Country:US
Mailing Address - Phone:603-540-7342
Mailing Address - Fax:
Practice Address - Street 1:47 BROCK ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03867-4436
Practice Address - Country:US
Practice Address - Phone:603-332-4090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-01
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2412235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist