Provider Demographics
NPI:1497909485
Name:CONNOR, MEREDITH CAITLIN
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:CAITLIN
Last Name:CONNOR
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 1:15 ANTRIM ROAD
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:NH
Mailing Address - Zip Code:03244
Mailing Address - Country:US
Mailing Address - Phone:603-464-3434
Mailing Address - Fax:
Practice Address - Street 1:15 ANTRIM RD
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:NH
Practice Address - Zip Code:03244-5250
Practice Address - Country:US
Practice Address - Phone:603-464-3434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-04
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CA60885104100000X
NH2680104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health