Provider Demographics
NPI:1326660911
Name:DUVAL, CHARLOTTE ANN
Entity Type:Individual
Prefix:
First Name:CHARLOTTE
Middle Name:ANN
Last Name:DUVAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NH
Mailing Address - Zip Code:03048-3211
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NH
Practice Address - Zip Code:03048-3211
Practice Address - Country:US
Practice Address - Phone:603-291-2017
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-18
Last Update Date:2020-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH112104OtherNH DOE