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General NPI Number Information
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NPI Number | 1265501605
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Entity Type | Individual
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Provider Name | SUSAN G VONDERHEIDE APRN, PH.D.
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Gender | Female
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Dates
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Enumeration Date | 11/07/2006
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Last Update Date | 01/22/2025
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Provider Practice Location Address
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Address Line | 3B TAGGART DR
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City | NASHUA
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State | NH
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Zip | 03060-5592
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Country | US
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Telephone | 603-891-1152
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Fax | 603-881-9744
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Provider Business Mailing Address
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Address Line | 3B TAGGART DR
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City | NASHUA
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State | NH
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Zip | 03060-5592
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Country | US
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Telephone | 603-891-1152
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Fax | 603-881-9744
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 392
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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 | 066468-23
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License Number State | NH
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