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General NPI Number Information
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NPI Number | 1285404954
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Entity Type | Individual
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Provider Name | JUSTIN CHRISTIAN
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Gender | Male
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Dates
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Enumeration Date | 01/04/2024
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Last Update Date | 08/07/2024
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Provider Practice Location Address
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Address Line | 112 S STATE ST
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City | CONCORD
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State | NH
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Zip | 03301-3528
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Country | US
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Telephone | 603-998-4210
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Fax | 603-532-0720
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Provider Business Mailing Address
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Address Line | 9 APPLE WAY
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City | STRATHAM
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State | NH
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Zip | 03885-2502
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Country | US
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Telephone | 184-305-3208
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State | NH
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