Provider Demographics
NPI:1316287238
Name:THERRIEN-BOLL, NICOLE (MA, LCMHC)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:THERRIEN-BOLL
Suffix:
Gender:F
Credentials:MA, LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 HIGH STREET
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060-0012
Mailing Address - Country:US
Mailing Address - Phone:603-821-7788
Mailing Address - Fax:603-821-5620
Practice Address - Street 1:45 HIGH STREET
Practice Address - Street 2:HARBOR CARE HEALTH AND WELLNESS CENTER
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-3312
Practice Address - Country:US
Practice Address - Phone:603-821-7788
Practice Address - Fax:603-821-5620
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-01
Last Update Date:2013-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH438101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health