Provider Demographics
NPI:1518580802
Name:SOUTHERN NEW HAMPSHIRE NEUROPSYCHOLOGY
Entity Type:Organization
Organization Name:SOUTHERN NEW HAMPSHIRE NEUROPSYCHOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL NEUROPSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:L
Authorized Official - Last Name:RICHARDS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:603-373-8782
Mailing Address - Street 1:2299 WOODBURY AVE STE 4-1
Mailing Address - Street 2:
Mailing Address - City:NEWINGTON
Mailing Address - State:NH
Mailing Address - Zip Code:03801-7831
Mailing Address - Country:US
Mailing Address - Phone:603-373-8782
Mailing Address - Fax:888-793-0432
Practice Address - Street 1:2299 WOODBURY AVE STE 4-1
Practice Address - Street 2:
Practice Address - City:NEWINGTON
Practice Address - State:NH
Practice Address - Zip Code:03801-7831
Practice Address - Country:US
Practice Address - Phone:603-373-8782
Practice Address - Fax:888-793-0432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-21
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty