Healthcare Provider Details

I. General information

NPI: 1679890453
Provider Name (Legal Business Name): CAROLINE JANE CHRISTIE MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CAROLINE JANE DUPREE MSW

II. Dates (important events)

Enumeration Date: 05/03/2010
Last Update Date: 05/16/2024
Certification Date: 05/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 LYME RD STE 200
HANOVER NH
03755-1260
US

IV. Provider business mailing address

PO BOX 1347
GRANTHAM NH
03753-1347
US

V. Phone/Fax

Practice location:
  • Phone: 603-932-5719
  • Fax:
Mailing address:
  • Phone: 802-318-7635
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2910
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: