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NPI Code Detail

MEDICARE: THERESA JANE FERNS M.A., PH.D.

MEDICARE: THERESA JANE FERNS M.A., PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor262NH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1447473673
Entity Type Code : Individual
Provider Name (Legal Business Name) : THERESA JANE FERNS M.A., PH.D.
Provider Business Mailing Address
First Line : 85 WARREN ST
Second Line :
City : CONCORD
State : NH
Zip : 03301-3837
Country : US
Telephone Number : 603-224-2841
Fax Number : 603-228-6018
Provider Business Practice Location Address
First Line : 85 WARREN ST
Second Line :
City : CONCORD
State : NH
Zip : 03301-3837
Country : US
Telephone Number : 603-224-2841
Fax Number : 603-228-6018
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2007
Last Update Date : 07/08/2007

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