Provider Demographics
NPI:1124271218
Name:GUYET, KATHRYN MARY (MLADC)
Entity type:Individual
Prefix:MISS
First Name:KATHRYN
Middle Name:MARY
Last Name:GUYET
Suffix:
Gender:F
Credentials:MLADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6 COUNTRY CLUB DR APT 35
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03102-8720
Mailing Address - Country:US
Mailing Address - Phone:407-619-1814
Mailing Address - Fax:
Practice Address - Street 1:89 N STATE ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301
Practice Address - Country:US
Practice Address - Phone:603-341-2938
Practice Address - Fax:603-290-5667
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-03
Last Update Date:2019-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0962101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3102769Medicaid