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NPI Code Detail

MEDICARE: RENE OUELLET LICSW

MEDICARE: RENE OUELLET LICSW
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
11041C0700XClinical Social Worker759NH

General Provider Information

NPI Number : 1336258318
Entity Type Code : Individual
Provider Name (Legal Business Name) : RENE OUELLET LICSW
Provider Business Mailing Address
First Line : 250 COMMERCIAL STREET
Second Line : SUITE 3004
City : MANCHESTER
State : NH
Zip : 03101-1118
Country : US
Telephone Number : 603-668-3050
Fax Number : 603-668-8666
Provider Business Practice Location Address
First Line : 250 COMMERCIAL STREET
Second Line : SUITE 3004
City : MANCHESTER
State : NH
Zip : 03101-1118
Country : US
Telephone Number : 603-668-3050
Fax Number : 603-668-8666
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2006
Last Update Date : 08/27/2014

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Directions to “ RENE OUELLET LICSW” Practice Location

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