Healthcare Provider Details

I. General information

NPI: 1831188663
Provider Name (Legal Business Name): CHRISTOPHER JOHN HEALEY MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/14/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 PROSPECT ST
NASHUA NH
03060
US

IV. Provider business mailing address

15 PROSPECT ST
NASHUA NH
03060
US

V. Phone/Fax

Practice location:
  • Phone: 603-889-6147
  • Fax: 603-594-9649
Mailing address:
  • Phone: 603-889-6147
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: