Provider Demographics
NPI:1063255149
Name:O'MEARA, CHRISTINE
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:O'MEARA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 CHAPEL LN
Mailing Address - Street 2:
Mailing Address - City:HOLDERNESS
Mailing Address - State:NH
Mailing Address - Zip Code:03245-5007
Mailing Address - Country:US
Mailing Address - Phone:732-245-6827
Mailing Address - Fax:
Practice Address - Street 1:1 WARREN ST
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03264-1416
Practice Address - Country:US
Practice Address - Phone:603-238-3149
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2830101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health