Provider Demographics
NPI:1326133554
Name:CARIGNAN, EDOUARD ANDRE JOSEPH (PSYD)
Entity Type:Individual
Prefix:DR
First Name:EDOUARD
Middle Name:ANDRE JOSEPH
Last Name:CARIGNAN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:BOW
Mailing Address - State:NH
Mailing Address - Zip Code:03304-3416
Mailing Address - Country:US
Mailing Address - Phone:603-856-8033
Mailing Address - Fax:603-856-8034
Practice Address - Street 1:501 SOUTH ST
Practice Address - Street 2:
Practice Address - City:BOW
Practice Address - State:NH
Practice Address - Zip Code:03304-3416
Practice Address - Country:US
Practice Address - Phone:603-856-8033
Practice Address - Fax:603-856-8034
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2015-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1058103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3072619Medicaid
NHCA-RE8515Medicare ID - Type UnspecifiedPSYCHOLOGIST