Healthcare Provider Details

I. General information

NPI: 1205498052
Provider Name (Legal Business Name): RHIANNON ARCHER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2019
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 TINKHAM AVENUE UNIT 101
DERRY NH
03038-1446
US

IV. Provider business mailing address

4 TINKHAM AVE UNIT 101
DERRY NH
03038-1446
US

V. Phone/Fax

Practice location:
  • Phone: 603-802-2396
  • Fax:
Mailing address:
  • Phone: 603-802-2396
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-22-57935
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: