Individual
LILA ZIVA ROSENBLOOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW, MLADC
Contact information
Practice address
718 SMYTH RD, MANCHESTER, NH 03104-7007
(603) 624-4366
Mailing address
718 SMYTH RD, MANCHESTER, NH 03104-7007
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
151.0134092
VT
101YA0400X
Addiction (Substance Use Disorder) Counselor
1514
NH
1041C0700X
Clinical Social Worker
Primary
2568
NH
1041C0700X
Clinical Social Worker
LC22678
ME
Other
Enumeration date
04/13/2020
Last updated
06/05/2024
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