Provider Demographics
NPI:1174674345
Name:HUFFORD, DAYL (DMIN)
Entity Type:Individual
Prefix:
First Name:DAYL
Middle Name:
Last Name:HUFFORD
Suffix:
Gender:F
Credentials:DMIN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 MAIN ST STE 204
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079-3173
Mailing Address - Country:US
Mailing Address - Phone:603-890-6767
Mailing Address - Fax:603-893-6767
Practice Address - Street 1:130 MAIN ST STE 204
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079-3173
Practice Address - Country:US
Practice Address - Phone:603-890-6767
Practice Address - Fax:603-893-6767
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA847101YM0800X
NH38101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH650085YONH01OtherBLUE CROSS BLUE SHIELD
MA7001000L052OtherBLUE CROSS BLUE SHIELD
NH30422510Medicaid