Provider Demographics
NPI:1245498823
Name:CHILD HEALTH SERVICES
Entity type:Organization
Organization Name:CHILD HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONSULTING PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:FISH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:603-668-6629
Mailing Address - Street 1:1245 ELM STREET
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03101-1398
Mailing Address - Country:US
Mailing Address - Phone:603-668-6629
Mailing Address - Fax:603-622-7680
Practice Address - Street 1:1245 ELM STREET
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03101-1398
Practice Address - Country:US
Practice Address - Phone:603-668-6629
Practice Address - Fax:603-622-7680
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHILD HEALTH SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-05-30
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH473103TH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth ServiceGroup - Single Specialty