Healthcare Provider Details

I. General information

NPI: 1225684137
Provider Name (Legal Business Name): RHONDA L BISHOP LADC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2019
Last Update Date: 08/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2957 MAIN STREET, RTE. 302
BETHLEHEM NH
03574
US

IV. Provider business mailing address

262 COTTAGE ST STE 230
LITTLETON NH
03561-4143
US

V. Phone/Fax

Practice location:
  • Phone: 603-869-2210
  • Fax: 603-869-2355
Mailing address:
  • Phone: 603-259-3700
  • Fax: 603-444-0945

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number0589
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: