Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 213 | NH |
N | 103T00000X | Psychologist | 213 | NH |
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 043191-23-08 | NH |
NPI | 1023160397 |
---|---|
Provider Name | Elaine B. Reid |
First Address | Dover, NH 03820-3434 |
Second Address | Dover, NH 03820-3434 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2007 |
Last Update Date | 24/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
80627733 | (05) | NH |