Healthcare Provider Details

I. General information

NPI: 1467801811
Provider Name (Legal Business Name): JESSICA Y. RHEE PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2016
Last Update Date: 03/08/2021
Certification Date: 03/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

445 CYPRESS ST STE 8
MANCHESTER NH
03103-3600
US

IV. Provider business mailing address

445 CYPRESS ST STE 8
MANCHESTER NH
03103-3600
US

V. Phone/Fax

Practice location:
  • Phone: 603-662-8632
  • Fax:
Mailing address:
  • Phone: 603-662-8632
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number00014
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: