Provider Demographics
NPI:1144578725
Name:SAYRES, RONALD MOREY JR (MLADC)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:MOREY
Last Name:SAYRES
Suffix:JR
Gender:M
Credentials:MLADC
Other - Prefix:
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Mailing Address - Street 1:50 BRIDGE ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03101-1699
Mailing Address - Country:US
Mailing Address - Phone:603-836-5767
Mailing Address - Fax:603-836-1105
Practice Address - Street 1:50 BRIDGE ST
Practice Address - Street 2:SUITE 104
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03101-1699
Practice Address - Country:US
Practice Address - Phone:603-836-5767
Practice Address - Fax:603-836-1105
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-29
Last Update Date:2014-07-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH0878101YA0400X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)