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Individual

TIMOTHY WIGHT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LICSW

Contact information

Practice address
360 ROUTE 101 STE 13B, BEDFORD, NH 03110-5033
(603) 488-1773
(844) 907-2936
Mailing address
43 GRANITE ST, MELROSE, MA 02176-5801
(617) 771-6582

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3136239
NH
Enumeration date
09/21/2016
Last updated
09/24/2022
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