| NPI | 1447885777 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE L TIMMINS Credentialing Coordinator 603-233-9801 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2020-03-06 |
| Last Update Date | 2020-03-06 |