Croasdale, Mary

Croasdale, Mary is an individual health care provider with primary practice located at 25 W Main St , Conway NH 03818-6142. She recently has only one registered license in Behavioral Health & Social Service Providers / Counselor, which is considered as her primary health care specialty. Croasdale, Mary can be contacted via phone (603) 447-2111.

Contact Information

Primary practice address
25 W Main St Conway NH 03818-6142
Phone: (603) 447-2111
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X

Profile Details

NPI number 1790934719
LBN Legal business name Croasdale, Mary
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 15th, 2008
Last updated Sep 15th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790934719 NPPES
New Hampshire Other 7706638Y0NH01 ANTHEM
New Hampshire MEDICAID 81263824 ANTHEM

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