Healthcare Provider Details

I. General information

NPI: 1861312464
Provider Name (Legal Business Name): ALEXANDRA BOISE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

292 NH 101
AMHERST NH
03031-1730
US

IV. Provider business mailing address

PO BOX 10157
BEDFORD NH
03110-0157
US

V. Phone/Fax

Practice location:
  • Phone: 603-713-6474
  • Fax:
Mailing address:
  • Phone: 603-713-5409
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number5796
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: