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NPI Code Detail

MEDICARE: MS. MICHELLE JEAN-RAYMOND MA

MEDICARE: MS. MICHELLE JEAN-RAYMOND MA
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
1101YM0800XMental Health Counselor1051NH

General Provider Information

NPI Number : 1669585980
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MICHELLE JEAN-RAYMOND MA
Provider Business Mailing Address
First Line : PO BOX 2032
Second Line :
City : CONCORD
State : NH
Zip : 03302-2032
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 105 LOUDON RD BLDG 3
Second Line :
City : CONCORD
State : NH
Zip : 03301-5600
Country : US
Telephone Number : 603-228-0547
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/17/2006
Last Update Date : 05/29/2014

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