Healthcare Provider Details

I. General information

NPI: 1467716100
Provider Name (Legal Business Name): STEPHEN P DILLE II BA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: STEPHEN SHARMA DILLE

II. Dates (important events)

Enumeration Date: 06/27/2012
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 MEADOW RD APT 24
KEENE NH
03431-3962
US

IV. Provider business mailing address

121 MEADOW RD APT 24
KEENE NH
03431-3962
US

V. Phone/Fax

Practice location:
  • Phone: 603-852-2697
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number5957
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: