Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | 128183 | NH |
NPI | 1083239990 |
---|---|
Provider Name | Esther Wakefield |
First Address | Moultonborough, NH 03254-0115 |
Second Address | Somersworth, NH 03878-3023 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2020 |
Last Update Date | 16/06/2020 |