Individual
MELISSA K BASCOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
C/O CARE COORDINATION DEPARTMENT, 1 ELLIOT WAY, MANCHESTER, NH 03103
(603) 663-2739
(603) 663-2664
Mailing address
C/O CARE COORDINATION DEPARTMENT, 1 ELLIOT WAY, MANCHESTER, NH 03103
(603) 663-2739
(603) 663-2664
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2143
NH
Other
Enumeration date
10/12/2018
Last updated
10/12/2018
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