Provider Demographics
NPI:1235430588
Name:CLOUGH, PATRICIA ANN (MS, LMFT)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:ANN
Last Name:CLOUGH
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:MRS
Other - First Name:PATRICIA
Other - Middle Name:ANN
Other - Last Name:CLOUGH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:216 SMITH RD
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:ME
Mailing Address - Zip Code:04027-3122
Mailing Address - Country:US
Mailing Address - Phone:603-842-2309
Mailing Address - Fax:
Practice Address - Street 1:18 N MAIN ST UNIT 3
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03867-1964
Practice Address - Country:US
Practice Address - Phone:603-481-0921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-03
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH133106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist