| NPI | 1457923682 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA MEAD Manager 603-688-6726 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 261QM0801X |
| Enumeration Date | 2021-07-16 |
| Last Update Date | 2021-08-09 |