Provider Demographics
NPI:1609047638
Name:HARRIOTT, EVELYN C K (EDD)
Entity Type:Individual
Prefix:DR
First Name:EVELYN
Middle Name:C K
Last Name:HARRIOTT
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 MIDDLE RD
Mailing Address - Street 2:
Mailing Address - City:HANCOCK
Mailing Address - State:NH
Mailing Address - Zip Code:03449-5909
Mailing Address - Country:US
Mailing Address - Phone:603-371-7305
Mailing Address - Fax:
Practice Address - Street 1:314 MIDDLE RD
Practice Address - Street 2:
Practice Address - City:HANCOCK
Practice Address - State:NH
Practice Address - Zip Code:03449-5909
Practice Address - Country:US
Practice Address - Phone:603-371-7305
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-18
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1147103TB0200X, 103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical