Provider Demographics
NPI:1639437387
Name:SHEILA H. GARDNER, PHD, LLC
Entity Type:Organization
Organization Name:SHEILA H. GARDNER, PHD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:H
Authorized Official - Last Name:GARDNER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:603-508-0309
Mailing Address - Street 1:8 JENKINS CT
Mailing Address - Street 2:SUITE 405
Mailing Address - City:DURHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03824-2323
Mailing Address - Country:US
Mailing Address - Phone:603-508-0309
Mailing Address - Fax:603-509-9585
Practice Address - Street 1:8 JENKINS CT
Practice Address - Street 2:SUITE 405
Practice Address - City:DURHAM
Practice Address - State:NH
Practice Address - Zip Code:03824-2323
Practice Address - Country:US
Practice Address - Phone:603-508-0309
Practice Address - Fax:603-509-9585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-01
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH995103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty