Provider Demographics
NPI:1669005138
Name:PHILIPPE, KERLANDE
Entity Type:Individual
Prefix:
First Name:KERLANDE
Middle Name:
Last Name:PHILIPPE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03101-1957
Mailing Address - Country:US
Mailing Address - Phone:857-256-4983
Mailing Address - Fax:
Practice Address - Street 1:20 MARKET ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03101-1957
Practice Address - Country:US
Practice Address - Phone:857-256-4983
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-12
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)