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Organization

GREEN HOUSE GROUP PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MELISSA WALLACE PSYD (VICE PRESIDENT)
(603) 668-3050
Entity
Organization

Contact information

Practice address
250 COMMERCIAL STREET, SUITE 3004, MANCHESTER, NH 03101-1118
(603) 668-3050
(603) 668-8666
Mailing address
250 COMMERCIAL STREET, SUITE 3004, MANCHESTER, NH 03101
(603) 668-3050
(603) 668-8666

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
512
NH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3076407
NH
05
3076408
NH
Enumeration date
05/18/2007
Last updated
07/10/2023
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