Individual
ALLY AUDREY TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
476C PAR DR, PEMBROKE, NH 03275-3280
(978) 504-1397
Mailing address
476C PAR DR, PEMBROKE, NH 03275-3280
(978) 504-1397
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103K00000X
Behavior Analyst
Primary
1-22-62222
NH
Other
Enumeration date
09/11/2018
Last updated
09/24/2025
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