Provider Demographics
NPI:1710105226
Name:THEO-STEELMAN, VIRGINIA (EDD)
Entity Type:Individual
Prefix:DR
First Name:VIRGINIA
Middle Name:
Last Name:THEO-STEELMAN
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83 HANOVER ST
Mailing Address - Street 2:#2
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03101-2216
Mailing Address - Country:US
Mailing Address - Phone:603-669-5575
Mailing Address - Fax:603-647-4143
Practice Address - Street 1:83 HANOVER ST
Practice Address - Street 2:#2
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03101-2216
Practice Address - Country:US
Practice Address - Phone:603-669-5575
Practice Address - Fax:603-647-4143
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH59103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling