Healthcare Provider Details

I. General information

NPI: 1710517628
Provider Name (Legal Business Name): MEGHAN SLAALIEN LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2020
Last Update Date: 05/10/2022
Certification Date: 05/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

154 BROAD ST STE 1511
NASHUA NH
03063-3205
US

IV. Provider business mailing address

154 BROAD ST STE 1511
NASHUA NH
03063-3205
US

V. Phone/Fax

Practice location:
  • Phone: 603-577-5551
  • Fax: 603-577-5576
Mailing address:
  • Phone: 603-577-5551
  • Fax: 603-577-5576

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: