Healthcare Provider Details

I. General information

NPI: 1457380396
Provider Name (Legal Business Name): SHEILA D RENAUD FINNEGAN LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1361 ELM ST SUITE 407 GREEN HOUSE GROUP
MANCHESTER NH
03101
US

IV. Provider business mailing address

1361 ELM ST SUITE 407 GREEN HOUSE GROUP
MANCHESTER NH
03101
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 Code104100000X
TaxonomySocial Worker
License Number46
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: