MEDICARE: ROBIN WINTER-WEBER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1245872183
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBIN WINTER-WEBER

Provider Business Mailing Address
First Line	:	PO BOX 171
Second Line	:
City	:	KEARSARGE
State	:	NH
Zip	:	03847-0171
Country	:	US
Telephone Number	:	603-387-7392
Fax Number	:

Provider Business Practice Location Address
First Line	:	2473 WHITE MOUNTAIN HIGHWAY
Second Line	:
City	:	N. CONWAY
State	:	NH
Zip	:	03860-0386
Country	:	US
Telephone Number	:	603-387-7392
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ROBIN E WINTER-WEBER
Credential	:	MA
Telephone Number	:	603-387-7392

Provider Enumeration Date	:	10/11/2019
Last Update Date	:	10/11/2019

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