Organization
WILD IRISH FARM, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LAURA M PETERSON LICSW (CLINICIAN)
(603) 436-2022
Entity
Organization
Contact information
Practice address
408 NEWINGTON RD, NEWINGTON, NH 03801-2730
(603) 436-2022
Mailing address
408 NEWINGTON RD, NEWINGTON, NH 03801-2730
(603) 436-2022
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1345
NH
Other
Enumeration date
09/06/2011
Last updated
09/06/2011
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