Provider Demographics
NPI:1467405142
Name:EYSSI-DOW, DONNA M (LICSW)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:M
Last Name:EYSSI-DOW
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1B COMMONS DR
Mailing Address - Street 2:SUITE #7
Mailing Address - City:LONDONDERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03053-3478
Mailing Address - Country:US
Mailing Address - Phone:603-560-0695
Mailing Address - Fax:
Practice Address - Street 1:1B COMMONS DR
Practice Address - Street 2:SUITE #7
Practice Address - City:LONDONDERRY
Practice Address - State:NH
Practice Address - Zip Code:03053-3478
Practice Address - Country:US
Practice Address - Phone:603-560-0695
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHNH7701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical