Provider Demographics
NPI:1497234744
Name:ST. HILAIRE, ELYSE
Entity Type:Individual
Prefix:
First Name:ELYSE
Middle Name:
Last Name:ST. HILAIRE
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 1:7 DANIEL RD
Mailing Address - Street 2:
Mailing Address - City:DERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03038-5275
Mailing Address - Country:US
Mailing Address - Phone:603-391-9219
Mailing Address - Fax:
Practice Address - Street 1:25 S RIVER RD STE 307
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6716
Practice Address - Country:US
Practice Address - Phone:603-242-2296
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-08
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH24841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical