Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0401X | Internist - Addiction Medicine | 039772-21 | NH |
NPI | 1578145926 |
---|---|
Provider Name | Katherine Ann Childs |
First Address | Somersworth, NH 03878-1119 |
Second Address | Somersworth, NH 03878-1119 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2021 |
Last Update Date | 26/04/2021 |