MEDICARE: DR. DORIS HAUERT

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	103TC0700X	Clinical Psychologist	9929	MA

General Provider Information

NPI Number	:	1477961597
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DORIS HAUERT

Provider Business Mailing Address
First Line	:	PO BOX 575
Second Line	:
City	:	WEST CHESTERFIELD
State	:	NH
Zip	:	03466
Country	:	US
Telephone Number	:	802-258-0643
Fax Number	:

Provider Business Practice Location Address
First Line	:	150 FEARING ST STE 14
Second Line	:
City	:	AMHERST
State	:	MA
Zip	:	01002-1942
Country	:	US
Telephone Number	:	802-258-0643
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/01/2014
Last Update Date	:	08/01/2014

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