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General NPI Number Information
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NPI Number | 1134219678
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Entity Type | Individual
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Provider Name | JOAN KUNDIN DOUBLEDAY LICSW
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Gender | Female
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Dates
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Enumeration Date | 10/13/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 20 W PARK ST
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City | LEBANON
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State | NH
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Zip | 03766-1378
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Country | US
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Telephone | 603-448-9925
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Fax | 802-295-2441
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Provider Business Mailing Address
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Address Line | 20 W PARK ST
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City | LEBANON
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State | NH
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Zip | 03766-1378
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Country | US
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Telephone | 603-448-9925
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Fax | 802-295-2441
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 239
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 181
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License Number State | VT
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