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General NPI Number Information
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NPI Number | 1639638760
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Entity Type | Individual
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Provider Name | MATHEW HUUSKO IV CRSW
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Gender | Male
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Dates
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Enumeration Date | 03/18/2019
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Last Update Date | 03/18/2019
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Provider Practice Location Address
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Address Line | 12 AMHERST ST
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City | NASHUA
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State | NH
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Zip | 03064-2663
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Country | US
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Telephone | 603-263-6444
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Fax | 603-931-3719
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Provider Business Mailing Address
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Address Line | 34 FRANKLIN ST STE LL13
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City | NASHUA
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State | NH
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Zip | 03064-2686
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Country | US
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Telephone | 603-343-6368
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Fax | 603-617-2846
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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 | 0176
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License Number State | NH
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