Full Name | |
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Speciality | Psychologist - Group Psychotherapy |
Location | 441 Bog Road, Stratford, New Hampshire |
Authorized Official Name and Position | Alta L Chase (PRESIDENT) |
Authorized Official Contact | 6036369914 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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441 Bog Road Stratford NH 03590 Ph: (603) 636-9914 | 441 Bog Road Stratford NH 03590 Ph: (603) 636-9914 |
NPI Number | 1083781199 |
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Provider Enumeration Date | 11/30/2006 |
Last Update Date | 04/30/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1083781199 | NPI | - | NPPES |
30421051 | Medicaid | NH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TP2701X | Psychologist - Group Psychotherapy | 61 (New Hampshire) | Primary |