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General NPI Number Information
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NPI Number | 1053720391
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Entity Type | Organization
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Legal Business Name | AUTUMN RECOVERY PLLC
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Dates
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Enumeration Date | 08/12/2014
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Last Update Date | 08/12/2014
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Provider Practice Location Address
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Address Line | 73 COURT ST APT A
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City | KEENE
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State | NH
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Zip | 03431-3437
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Country | US
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Telephone | 603-363-4383
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 663
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City | KEENE
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State | NH
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Zip | 03431-0663
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Country | US
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Telephone | 603-363-4383
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Fax |
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Authorized Official
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Title or Position | PSYCHIATRIST
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Name | DR. ELIZABETH H JOSEPH
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Credential | D.O.
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Telephone | 603-363-4383
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 15029
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License Number State | NH
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