Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | ||
Y | 103G00000X | Clinical Psychologist | 1179 | NH |
Y | 103TC0700X | Clinical Psychologist | 1179 | NH |
NPI | 1003981374 |
---|---|
Provider Name | Dr. Michael Hendery |
First Address | Dover, NH 03820-3890 |
Second Address | Dover, NH 03820-3890 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/11/2006 |
Last Update Date | 07/01/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7706655Y0NH01 | BHN (01) | NH |
99003227 | (05) | NH |