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Organization
EBBTIDE BEHAVIORAL HEALTH ASSOCIATES PLLC
Active
Organization
EBBTIDE BEHAVIORAL HEALTH ASSOCIATES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TASHA L HUMPHREYS APRN (PROVIDER)
(802) 793-9177
Entity
Organization
Contact information
Practice address
83 LAFAYETTE RD UNIT 47-B, HAMPTON FALLS, NH 03844-2303
(802) 793-9177
Mailing address
83 LAFAYETTE RD UNIT 47-B, HAMPTON FALLS, NH 03844-2303
(802) 793-9177
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3095969
—
NH
Enumeration date
02/28/2023
Last updated
08/09/2023
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