Healthcare Provider Details

I. General information

NPI: 1598907412
Provider Name (Legal Business Name): LAURENCE ELIZABETH HECKSCHER L.P.P
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2009
Last Update Date: 03/25/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 ERMER ROAD SUITE 215
SALEM NH
03079-1272
US

IV. Provider business mailing address

7 WILDEMERE TER
CONCORD NH
03301-2575
US

V. Phone/Fax

Practice location:
  • Phone: 603-890-6767
  • Fax:
Mailing address:
  • Phone: 603-225-9302
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number64
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: