Healthcare Provider Details

I. General information

NPI: 1255880860
Provider Name (Legal Business Name): JANICE PEIGHTELL MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2016
Last Update Date: 09/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

183 HIGH STREET
CANDIA NH
03034-0320
US

IV. Provider business mailing address

183 HIGH STREET P.O. BOX 320
CANDIA NH
03034-0320
US

V. Phone/Fax

Practice location:
  • Phone: 603-483-2886
  • Fax: 603-483-0161
Mailing address:
  • Phone: 603-483-2886
  • Fax: 603-483-0161

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number806
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: