MEDICARE: PATRICIA E SHEA PSY.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
1	103T00000X	Psychologist	986	NH

General Provider Information

NPI Number	:	1750656450
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA E SHEA PSY.D.

Provider Business Mailing Address
First Line	:	218 EAST RD
Second Line	:
City	:	HAMPSTEAD
State	:	NH
Zip	:	03841-2305
Country	:	US
Telephone Number	:	603-329-5311
Fax Number	:	603-329-9374

Provider Business Practice Location Address
First Line	:	218 EAST RD
Second Line	:
City	:	HAMPSTEAD
State	:	NH
Zip	:	03841-2305
Country	:	US
Telephone Number	:	603-329-5311
Fax Number	:	603-329-9374

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/13/2012
Last Update Date	:	03/13/2012

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