Provider Demographics
NPI:1659339463
Name:DEMPSTER, CLIFFORD R (PH D)
Entity Type:Individual
Prefix:DR
First Name:CLIFFORD
Middle Name:R
Last Name:DEMPSTER
Suffix:
Gender:M
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 CLINTON ST
Mailing Address - Street 2:NEW HAMPSHIRE HOSPITAL
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-2359
Mailing Address - Country:US
Mailing Address - Phone:603-271-5503
Mailing Address - Fax:603-271-5395
Practice Address - Street 1:36 CLINTON ST
Practice Address - Street 2:NEW HAMPSHIRE HOSPITAL
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-2359
Practice Address - Country:US
Practice Address - Phone:603-271-5503
Practice Address - Fax:603-271-5395
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-02
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH547103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist