Provider Demographics
NPI:1639366990
Name:BEAN, ADELE MAREE (MS)
Entity Type:Individual
Prefix:MRS
First Name:ADELE
Middle Name:MAREE
Last Name:BEAN
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 1:321 STAGE RD
Mailing Address - Street 2:
Mailing Address - City:NOTTINGHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03290-6207
Mailing Address - Country:US
Mailing Address - Phone:603-734-2467
Mailing Address - Fax:
Practice Address - Street 1:321 STAGE RD
Practice Address - Street 2:
Practice Address - City:NOTTINGHAM
Practice Address - State:NH
Practice Address - Zip Code:03290-6207
Practice Address - Country:US
Practice Address - Phone:603-734-2467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-01
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1956225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist