Provider Demographics
NPI:1780748301
Name:OLIVER, CELIA GAIL (PHD, PSYD)
Entity type:Individual
Prefix:DR
First Name:CELIA
Middle Name:GAIL
Last Name:OLIVER
Suffix:
Gender:F
Credentials:PHD, PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 MAIN ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:PETERBOROUGH
Mailing Address - State:NH
Mailing Address - Zip Code:03458-2447
Mailing Address - Country:US
Mailing Address - Phone:603-924-6400
Mailing Address - Fax:603-924-6437
Practice Address - Street 1:45 MAIN ST
Practice Address - Street 2:SUITE 201
Practice Address - City:PETERBOROUGH
Practice Address - State:NH
Practice Address - Zip Code:03458-2447
Practice Address - Country:US
Practice Address - Phone:603-924-6400
Practice Address - Fax:603-924-6437
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH845103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHRE6336Medicaid
NHP37580Medicare UPIN