Provider Demographics
NPI:1497427884
Name:LIQUE NAITOVE, PETER DANIEL (SCHOOL PSYCHOLOGIST)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:DANIEL
Last Name:LIQUE NAITOVE
Suffix:
Gender:M
Credentials:SCHOOL PSYCHOLOGIST
Other - Prefix:DR
Other - First Name:PETER
Other - Middle Name:
Other - Last Name:NAITOVE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:SCHOOL PSYCHOLOGIST
Mailing Address - Street 1:25 ALUMNI DR
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-4365
Mailing Address - Country:US
Mailing Address - Phone:603-516-6912
Mailing Address - Fax:603-516-6886
Practice Address - Street 1:25 ALUMNI DR
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-4365
Practice Address - Country:US
Practice Address - Phone:603-516-6912
Practice Address - Fax:603-516-8668
Is Sole Proprietor?:No
Enumeration Date:2021-10-04
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH105934103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool