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General NPI Number Information
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NPI Number | 1568945558
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Entity Type | Individual
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Provider Name | CHRISTOPHER AVDOIAN LICSW
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Gender | Male
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Dates
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Enumeration Date | 09/14/2018
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Last Update Date | 09/14/2018
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Provider Practice Location Address
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Address Line | 3 FERRY ST
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City | BRADFORD
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State | MA
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Zip | 01835-7442
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Country | US
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Telephone | 978-469-8821
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Fax |
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Provider Business Mailing Address
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Address Line | 128 NEWTON RD UNIT 13
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City | PLAISTOW
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State | NH
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Zip | 03865-2425
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Country | US
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Telephone | 603-974-2979
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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 | 112203
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License Number State | MA
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