Provider Demographics
NPI:1518173541
Name:FIRESTINE, ANN M (MS)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:M
Last Name:FIRESTINE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 CLINTON ST
Mailing Address - Street 2:NEW HAMPSHIRE HOSPITAL
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-2359
Mailing Address - Country:US
Mailing Address - Phone:603-271-5470
Mailing Address - Fax:603-271-5395
Practice Address - Street 1:36 CLINTON ST
Practice Address - Street 2:NEW HAMPSHIRE HOSPITAL
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-2359
Practice Address - Country:US
Practice Address - Phone:603-271-5470
Practice Address - Fax:603-271-5395
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health