Provider Demographics
NPI:1164001087
Name:HOLLIS BROOKLINE HIGH SCHOOL
Entity Type:Organization
Organization Name:HOLLIS BROOKLINE HIGH SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SCHOOL PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:NH #30053
Authorized Official - Phone:603-809-3386
Mailing Address - Street 1:HOLLIS BROOKLINE HIGH SCHOOL
Mailing Address - Street 2:24 CAVALIER COURT
Mailing Address - City:HOLLIS
Mailing Address - State:NH
Mailing Address - Zip Code:03049
Mailing Address - Country:US
Mailing Address - Phone:603-809-3386
Mailing Address - Fax:
Practice Address - Street 1:HOLLIS BROOKLINE HIGH SCHOOL
Practice Address - Street 2:24 CAVALIER COURT
Practice Address - City:HOLLIS
Practice Address - State:NH
Practice Address - Zip Code:03049
Practice Address - Country:US
Practice Address - Phone:603-809-3386
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOLLIS BROOKLINE COOP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-04-07
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3079121Medicaid