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General NPI Number Information
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NPI Number | 1669842183
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Entity Type | Organization
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Legal Business Name | PHYLLIS CRAIG, PHD, INC
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Dates
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Enumeration Date | 09/26/2015
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Last Update Date | 09/26/2015
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Provider Practice Location Address
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Address Line | 24 FRONT ST
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City | EXETER
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State | NH
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Zip | 03833-2727
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Country | US
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Telephone | 603-778-0505
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Fax | 603-772-6761
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Provider Business Mailing Address
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Address Line | 24 FRONT ST
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City | EXETER
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State | NH
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Zip | 03833-2727
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Country | US
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Telephone | 603-778-0505
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Fax | 603-772-6761
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Authorized Official
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Title or Position | PROVIDER
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Name | MS. PHYLLIS LEE CRAIG
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Credential | PHD
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Telephone | 603-778-0505
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 1033
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License Number State | NH
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