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General NPI Number Information
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NPI Number | 1235430588
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Entity Type | Individual
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Provider Name | PATRICIA ANN CLOUGH MS, LMFT
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Gender | Female
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Dates
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Enumeration Date | 11/03/2010
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Last Update Date | 09/20/2018
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Provider Practice Location Address
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Address Line | 18 N MAIN ST UNIT 3
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City | ROCHESTER
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State | NH
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Zip | 03867-1964
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Country | US
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Telephone | 603-481-0921
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Fax |
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Provider Business Mailing Address
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Address Line | 216 SMITH RD
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City | LEBANON
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State | ME
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Zip | 04027-3122
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Country | US
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Telephone | 603-842-2309
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Fax |
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 133
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License Number State | NH
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