Individual
MRS. PRISCILLA F BOURGOINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
39 SIMON ST, 2A, NASHUA, NH 03060-3046
(603) 888-4347
(603) 577-9157
Mailing address
39 SIMON ST., 2A, NASHUA, NH 03060
(603) 888-4347
(603) 577-9157
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
356
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1699943449
MEDICARE PTAN
NH
05
—
30009530
—
NH
Enumeration date
02/14/2008
Last updated
10/03/2012
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