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General NPI Number Information
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NPI Number | 1023160397
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Entity Type | Individual
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Provider Name | ELAINE B. REID
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Gender | Female
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 09/24/2012
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Provider Practice Location Address
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Address Line | 750 CENTRAL AVE SUITE G
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City | DOVER
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State | NH
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Zip | 03820-3434
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Country | US
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Telephone | 603-742-1097
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Fax | 603-742-5762
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Provider Business Mailing Address
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Address Line | 750 CENTRAL AVE SUITE G
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City | DOVER
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State | NH
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Zip | 03820-3434
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Country | US
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Telephone | 603-742-1097
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Fax | 603-742-5762
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 213
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 043191-23-08
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License Number State | NH
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