Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | 90334 | NH |
NPI | 1023607090 |
---|---|
Provider Name | Dr. Michelle Manseau |
First Address | Bedford, NH 03110-4400 |
Second Address | Peterborough, NH 03458-2404 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/01/2021 |
Last Update Date | 14/01/2021 |