Healthcare Provider Details

I. General information

NPI: 1245656230
Provider Name (Legal Business Name): MRS. MARTHA TURCOTTE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2014
Last Update Date: 03/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2957 MAIN STREET
BETHLEHEM NH
03574-0717
US

IV. Provider business mailing address

2957 MAIN STREET
BETHLEHEM NH
03574-0717
US

V. Phone/Fax

Practice location:
  • Phone: 603-869-2210
  • Fax: 603-869-2355
Mailing address:
  • Phone: 603-869-2210
  • Fax: 603-869-2355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number0022
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: