Provider Demographics
NPI:1699815506
Name:HOWARD, LARAINE STELLA (BA)
Entity Type:Individual
Prefix:MS
First Name:LARAINE
Middle Name:STELLA
Last Name:HOWARD
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 11
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:NH
Mailing Address - Zip Code:03465-0011
Mailing Address - Country:US
Mailing Address - Phone:603-357-5270
Mailing Address - Fax:603-357-6875
Practice Address - Street 1:17 93RD ST
Practice Address - Street 2:
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431-3748
Practice Address - Country:US
Practice Address - Phone:603-357-5270
Practice Address - Fax:603-357-6875
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH171M00000XOtherCASE MANAGER