=====================================================
General NPI Number Information
=====================================================
NPI Number | 1154084341
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | NANCY DELEW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/15/2021
-----------------------------------------------------
Last Update Date | 10/15/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6 KITTY HAWK LNDG
-----------------------------------------------------
City | LONDONDERRY
-----------------------------------------------------
State | NH
-----------------------------------------------------
Zip | 03053-2045
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 603-432-6920
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6 KITTY HAWK LNDG
-----------------------------------------------------
City | LONDONDERRY
-----------------------------------------------------
State | NH
-----------------------------------------------------
Zip | 03053-2045
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TS0200X
-----------------------------------------------------
Taxonomy Name | School Psychologist
-----------------------------------------------------
License Number | 59825
-----------------------------------------------------
License Number State | NH
-----------------------------------------------------