Individual
THOMAS WALTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MED, CMHC
Contact information
Practice address
401 CYPRESS ST, MANCHESTER, NH 03103-3628
(603) 668-4111
Mailing address
401 CYPRESS ST, MANCHESTER, NH 03103-3628
(603) 668-4111
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
689
NH
101YM0800X
Mental Health Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7706660Y0NH01
BLUE CROSS
NH
Enumeration date
12/11/2006
Last updated
10/31/2007
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