Corriss, David

Corriss, David is an sole proprietor health care provider with primary practice located at 4 Back River Rd , Dover NH 03820-4404. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Corriss, David can be contacted via phone (603) 742-1373.

Contact Information

Primary practice address
4 Back River Rd Dover NH 03820-4404
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 879 New Hampshire
Behavioral Health & Social Service Providers / Clinical 103TC0700X 013544 New York

Profile Details

NPI number 1023153699
LBN Legal business name Corriss, David
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 21st, 2007
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023153699 NPPES
New Hampshire MEDICAID 30420045

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