Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 1096 | NH |
NPI | 1023233053 |
---|---|
Provider Name | Dr. Cheryl Lynne Withka |
First Address | Nashua, NH 03064-2716 |
Second Address | Epping, NH 03042-0180 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2007 |
Last Update Date | 28/10/2015 |