Individual
SAMANTHA CORINNE BOUTSIANIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRSW
Contact information
Practice address
206 JEWETT ST APT 2B, MANCHESTER, NH 03103-2879
(603) 603-8280
Mailing address
206 JEWETT ST APT 2B, MANCHESTER, NH 03103-2879
(603) 603-8280
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0217
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0217
—
NH
Enumeration date
09/23/2019
Last updated
09/23/2019
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