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Individual

MS. KATHRYN A STACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCMHC

Contact information

Practice address
111 CHURCH ST, LACONIA, NH 03246-3432
(603) 536-1118
Mailing address
45 MERRIMACK DR, MERRIMACK, NH 03054-4861
(630) 785-6005

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1018
NH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
30010118
NH
Enumeration date
01/22/2007
Last updated
06/11/2015
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