Healthcare Provider Details

I. General information

NPI: 1477583979
Provider Name (Legal Business Name): ANN L ROSOFF PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 10/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 COMMERCIAL ST SUITE 3004
MANCHESTER NH
03101-1142
US

IV. Provider business mailing address

250 COMMERCIAL ST SUITE 3004
MANCHESTER NH
03101-1142
US

V. Phone/Fax

Practice location:
  • Phone: 603-668-3050
  • Fax: 603-668-8666
Mailing address:
  • Phone: 603-668-3050
  • Fax: 603-668-8666

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number548
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: