Provider Demographics
NPI:1740892157
Name:RAICHE-STEPHENS, KATHY
Entity type:Individual
Prefix:MRS
First Name:KATHY
Middle Name:
Last Name:RAICHE-STEPHENS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 MECHANIC ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03101-1923
Mailing Address - Country:US
Mailing Address - Phone:603-232-8666
Mailing Address - Fax:
Practice Address - Street 1:117 MARKET ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03101-1933
Practice Address - Country:US
Practice Address - Phone:603-623-3558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-18
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator