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General NPI Number Information
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NPI Number | 1477738235
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Entity Type | Individual
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Provider Name | SHELLEY ANNA DRAKE LICSW
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Gender | Female
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Dates
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Enumeration Date | 12/29/2007
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Last Update Date | 09/25/2024
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Provider Practice Location Address
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Address Line | 2 CONCORD RD STE 2
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City | LEE
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State | NH
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Zip | 03861-6628
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Country | US
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Telephone | 603-828-5716
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Fax |
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Provider Business Mailing Address
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Address Line | 32 MAST RD
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City | LEE
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State | NH
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Zip | 03861-6518
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Country | US
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Telephone | 603-828-5716
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 1557
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License Number State | NH
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