Provider Demographics
NPI:1891562922
Name:EMDR NH
Entity Type:Organization
Organization Name:EMDR NH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:FABIOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:PAIVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-932-5190
Mailing Address - Street 1:326 MAIN ST UNIT 11
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:NH
Mailing Address - Zip Code:03044-3440
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:326 MAIN ST UNIT 11
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:NH
Practice Address - Zip Code:03044-3440
Practice Address - Country:US
Practice Address - Phone:603-232-9246
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-08
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)