| Doctor Name: | CONSTANCE JOHANNESSEN |
| NPI Number: | 1194840249 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSY, D. |
| License Number: | NH718 |
| Business Practice Address: | 155 Lafayette Rd Suite 3 North Hampton, NH - 038622464 |
| Business Phone Number: | 6039644869 |
| Business Fax Number: | 6039644980 |
| Mailing Address: | 155 Lafayette Rd, Suite 3 NORTH HAMPTON |
| State: | NH |
| Postal Code: | 038622464 |
| Phone Number: | 6039644869 |
| Fax Number: | 6039644980 |
| NPI Enumeration Date: | 03/20/2007 |
| NPI Last Update Date: | 03/25/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TB0200X |
| License Number: | NH718 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Cognitive & Behavioral |
| Taxonomy Definition: | |