Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003076688 |
---|---|
Provider Name | Tara Nelson |
First Address | Concord, NH 03302-2032 |
Second Address | Franklin, NH 03235-1413 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2008 |
Last Update Date | 17/06/2008 |