Organization
MINDFUL ALTERATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER TANNER OLGIATI LICSW (LICENSED CLINICAL SOCIAL WORKER)
(603) 998-1523
Entity
Organization
Contact information
Practice address
15 SCHOOL ST, DOVER, NH 03820-3529
(603) 998-1523
Mailing address
15 SCHOOL ST, DOVER, NH 03820-3529
(603) 998-1523
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1771
NH
Other
Enumeration date
12/22/2014
Last updated
12/22/2014
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