| Full Name | |
|---|---|
| Speciality | Behavior Analyst |
| Location | 144 Canal St, Nashua, New Hampshire |
| Authorized Official Name and Position | Mary Landry (BILLING MANAGER/SUPERVISOR) |
| Authorized Official Contact | 6034592795 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
144 Canal St Nashua NH 03064-2812 Ph: (603) 882-6333 | 144 Canal St Nashua NH 03064-2812 Ph: (603) 882-6333 |
| NPI Number | 1508920364 |
|---|---|
| Provider Enumeration Date | 12/19/2006 |
| Last Update Date | 03/03/2020 |
| Certification Date | 03/03/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508920364 | NPI | - | NPPES |
| 30580833 | Medicaid | NH | |
| 30590493 | Medicaid | NH | |
| 3116594 | Medicaid | NH |
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