Individual
GWEN C BOISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
7 PROSPECT ST, NASHUA, NH 03060-3921
(603) 889-6147
Mailing address
100 W PEARL ST, NASHUA, NH 03060-3343
(603) 889-6147
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1861568107
OTHER
—
Enumeration date
10/27/2021
Last updated
08/04/2022
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