Provider Demographics
NPI:1285183061
Name:COWHAM, RAYMOND JOSEPH II
Entity Type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:JOSEPH
Last Name:COWHAM
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03101-2201
Mailing Address - Country:US
Mailing Address - Phone:603-625-6980
Mailing Address - Fax:
Practice Address - Street 1:351 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03101-2201
Practice Address - Country:US
Practice Address - Phone:603-625-6980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-22
Last Update Date:2016-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0982101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor