Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 0088 | NH |
NPI | 1003348178 |
---|---|
Provider Name | Olivia Dupell |
First Address | Concord, NH 03301-5022 |
Second Address | Concord, NH 03301-5022 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2017 |
Last Update Date | 29/03/2017 |