Healthcare Provider Details

I. General information

NPI: 1871814343
Provider Name (Legal Business Name): REBECCA DOBLES LADC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2010
Last Update Date: 06/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 HANOVER ST
MANCHESTER NH
03101-2203
US

IV. Provider business mailing address

400 CALEF RD
MANCHESTER NH
03103-6689
US

V. Phone/Fax

Practice location:
  • Phone: 603-518-4000
  • Fax: 603-668-6260
Mailing address:
  • Phone: 603-361-4713
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number812
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: