Provider Demographics
NPI:1063780161
Name:GARRISON-BOTSFORD, HILARY SARA (MSW)
Entity type:Individual
Prefix:
First Name:HILARY
Middle Name:SARA
Last Name:GARRISON-BOTSFORD
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 MECHANIC ST
Mailing Address - Street 2:SUITE 360
Mailing Address - City:LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03766-1537
Mailing Address - Country:US
Mailing Address - Phone:603-448-5610
Mailing Address - Fax:
Practice Address - Street 1:85 MECHANIC ST
Practice Address - Street 2:SUITE 360
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03766-1537
Practice Address - Country:US
Practice Address - Phone:603-448-5610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-05
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHRE2534Medicare PIN