Provider Demographics
NPI:1740262237
Name:SKELLEY-PETERS, EVA M (LICSW)
Entity type:Individual
Prefix:MS
First Name:EVA
Middle Name:M
Last Name:SKELLEY-PETERS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:EPPING
Mailing Address - State:NH
Mailing Address - Zip Code:03042-3121
Mailing Address - Country:US
Mailing Address - Phone:603-734-2254
Mailing Address - Fax:603-734-2254
Practice Address - Street 1:322 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:EPPING
Practice Address - State:NH
Practice Address - Zip Code:03042-3121
Practice Address - Country:US
Practice Address - Phone:603-734-2254
Practice Address - Fax:603-734-2254
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH11841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical