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NPI Code Detail

MEDICARE: BETTE LEWICKE PH.D.

MEDICARE: BETTE LEWICKE PH.D.
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
1103G00000XClinical Neuropsychologist810NH
2103T00000XPsychologist810NH
3103TC2200XClinical Child & Adolescent Psychologist810NH
4103TA0700XAdult Development & Aging Psychologist810NH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1992757520
Entity Type Code : Individual
Provider Name (Legal Business Name) : BETTE LEWICKE PH.D.
Provider Business Mailing Address
First Line : 1 MAIN ST
Second Line :
City : NASHUA
State : NH
Zip : 03064-2716
Country : US
Telephone Number : 603-883-0005
Fax Number : 603-883-0007
Provider Business Practice Location Address
First Line : 1 MAIN ST
Second Line :
City : NASHUA
State : NH
Zip : 03064-2716
Country : US
Telephone Number : 603-883-0005
Fax Number : 603-883-0007
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2006
Last Update Date : 11/03/2011

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