Provider Demographics
NPI:1639818719
Name:RESONANCE MENTAL HEALTH, LLC
Entity Type:Organization
Organization Name:RESONANCE MENTAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOULANGER
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:603-473-4451
Mailing Address - Street 1:184 MAMMOTH RD UNIT 4
Mailing Address - Street 2:
Mailing Address - City:LONDONDERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03053-3254
Mailing Address - Country:US
Mailing Address - Phone:603-473-4451
Mailing Address - Fax:
Practice Address - Street 1:184 MAMMOTH RD
Practice Address - Street 2:SUITE 4
Practice Address - City:LONDONDERRY
Practice Address - State:NH
Practice Address - Zip Code:03053
Practice Address - Country:US
Practice Address - Phone:603-473-4451
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-27
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty