Provider Demographics
NPI:1265207872
Name:ARCHAMBAULT, HEATHER PHYLLIS (MSW)
Entity type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:PHYLLIS
Last Name:ARCHAMBAULT
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 MCGREGOR STREET
Mailing Address - Street 2:UNIT 400
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03102
Mailing Address - Country:US
Mailing Address - Phone:603-206-2700
Mailing Address - Fax:603-668-5443
Practice Address - Street 1:195 MCGREGOR STREET
Practice Address - Street 2:UNIT 400
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03102
Practice Address - Country:US
Practice Address - Phone:603-206-2700
Practice Address - Fax:603-668-5443
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-24
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical