Healthcare Provider Details

I. General information

NPI: 1447585948
Provider Name (Legal Business Name): PARTNERS IN FAMILY WELLNESS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2009
Last Update Date: 10/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 ERMER RD SUITE 208
SALEM NH
03079-1271
US

IV. Provider business mailing address

15 ERMER RD SUITE 208
SALEM NH
03079-1271
US

V. Phone/Fax

Practice location:
  • Phone: 603-898-3388
  • Fax: 603-898-3390
Mailing address:
  • Phone: 603-898-3388
  • Fax: 603-898-3390

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: JOAN FRANCES TAVARES
Title or Position: MEMBER
Credential: LICSW
Phone: 603-898-3388