| Wild Irish Farm, Llc | |
|
408 Newington Rd Newington NH 03801-2730 | |
| (603) 436-2022 | |
| Not Available |
| Full Name | Wild Irish Farm, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 408 Newington Rd, Newington, New Hampshire |
| Authorized Official Name and Position | Laura M Peterson (CLINICIAN) |
| Authorized Official Contact | 6034362022 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wild Irish Farm, Llc 408 Newington Rd Newington NH 03801-2730 Ph: (603) 436-2022 | Wild Irish Farm, Llc 408 Newington Rd Newington NH 03801-2730 Ph: (603) 436-2022 |
| NPI Number | 1285915199 |
|---|---|
| Provider Enumeration Date | 09/06/2011 |
| Last Update Date | 09/06/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285915199 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 1345 (New Hampshire) | Primary |
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