Provider Demographics
NPI:1932146107
Name:HESS, ELIZABETH P (PHD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:P
Last Name:HESS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:856 WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:NH
Mailing Address - Zip Code:03570-1017
Mailing Address - Country:US
Mailing Address - Phone:603-752-4475
Mailing Address - Fax:
Practice Address - Street 1:856 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:NH
Practice Address - Zip Code:03570-1017
Practice Address - Country:US
Practice Address - Phone:603-752-4475
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-31
Last Update Date:2010-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH960103T00000X
MA2984103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0516465Medicaid
NH30421717Medicaid
NHRE6469Medicare ID - Type Unspecified
NH30421717Medicaid