Doctor Name: | ELAINE-MARIE SURRELL |
NPI Number: | 1265602650 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSW, LICSW |
License Number: | 1628 |
Business Practice Address: | 273 Old Coach Rd New Boston, NH - 030704505 |
Business Phone Number: | 3364867971 |
Business Fax Number: | |
Mailing Address: | Po Box 102, NEW BOSTON |
State: | NH |
Postal Code: | 030700102 |
Phone Number: | 3364867971 |
Fax Number: | |
NPI Enumeration Date: | 03/03/2008 |
NPI Last Update Date: | 01/07/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 1628 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |