Doctor Name: | FRED BATES |
NPI Number: | 1174622419 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.ED., LCMHC, LADC |
License Number: | 460 |
Business Practice Address: | 302 Rockingham Rd Londonderry, NH - 030532103 |
Business Phone Number: | 6032964087 |
Business Fax Number: | 6032964089 |
Mailing Address: | 302 Rockingham Rd, LONDONDERRY |
State: | NH |
Postal Code: | 030532103 |
Phone Number: | 6032964087 |
Fax Number: | 6032964089 |
NPI Enumeration Date: | 09/22/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 460 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | NH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |