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Individual

MARK SHEARING

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LADC

Contact information

Practice address
16 MANNING ST, DERRY, NH 03038-2388
(603) 231-0214
Mailing address
16 MANNING ST, DERRY, NH 03038-2388
(603) 231-0214

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0839
LICENSED ALCOHOL & DRUG COUNSELOR
NH
Enumeration date
01/18/2012
Last updated
01/18/2012
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