Healthcare Provider Details

I. General information

NPI: 1326954371
Provider Name (Legal Business Name): GAIL B MOELLER LADC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 OPERA HOUSE SQ STE ME4
CLAREMONT NH
03743-5408
US

IV. Provider business mailing address

221 MAIN ST STE N
NASHUA NH
03060-2913
US

V. Phone/Fax

Practice location:
  • Phone: 603-802-5892
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number2150
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: