Healthcare Provider Details

I. General information

NPI: 1801175252
Provider Name (Legal Business Name): STEVI GELINAS NH CANDIDATE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2011
Last Update Date: 02/28/2024
Certification Date: 02/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 FIELD VIEW RD
FRYEBURG ME
04037-4360
US

IV. Provider business mailing address

PO BOX 351
FRYEBURG ME
04037-0351
US

V. Phone/Fax

Practice location:
  • Phone: 774-402-4791
  • Fax:
Mailing address:
  • Phone: 774-402-4791
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number1259
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: