Provider Demographics
NPI:1609061589
Name:VALERIE A. DRASKOVICH
Entity Type:Organization
Organization Name:VALERIE A. DRASKOVICH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:DRASKOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-488-5557
Mailing Address - Street 1:3 BRAEBURN CT
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-4433
Mailing Address - Country:US
Mailing Address - Phone:603-488-5557
Mailing Address - Fax:
Practice Address - Street 1:753 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03104-3011
Practice Address - Country:US
Practice Address - Phone:603-703-6779
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-13
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6373101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty