Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor | 2 | NH |
NPI | 1285701508 |
---|---|
Provider Name | Edward Mahoney |
First Address | Manchester, NH 03101-1518 |
Second Address | Manchester, NH 03101-1518 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2006 |
Last Update Date | 31/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
020258994-95 | HARVARD PILGRIM (01) | NH |
2169237 | CIGNA (01) | NH |
6500184Y0NH02 | BLUE CROSS (01) | NH |