Provider Demographics
NPI:1609835263
Name:HAYWOOD-NILER, ELIZABETH (PHD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:HAYWOOD-NILER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 OLD DOVER RD
Mailing Address - Street 2:SUITE ONE
Mailing Address - City:ROCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03867-3460
Mailing Address - Country:US
Mailing Address - Phone:603-335-2444
Mailing Address - Fax:603-335-2226
Practice Address - Street 1:660 CENTRAL AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-3491
Practice Address - Country:US
Practice Address - Phone:603-743-2223
Practice Address - Fax:603-749-3365
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH652103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH0609039Y0NH01OtherANTHEM
NH30010617Medicaid
R74597Medicare UPIN
NH30010617Medicaid