Healthcare Provider Details

I. General information

NPI: 1083991491
Provider Name (Legal Business Name): WILLIAM SLAMMON PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2011
Last Update Date: 11/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 S VILLAGE RD
WESTMORELAND NH
03467-4518
US

IV. Provider business mailing address

112 S VILLAGE RD
WESTMORELAND NH
03467-4518
US

V. Phone/Fax

Practice location:
  • Phone: 603-209-4450
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number830
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number830
License Number StateNH
# 3
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number830
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: