Basic Information
Provider Information
NPI: 1619633971
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MORSE
FirstName: CHRISTINE
MiddleName: M
NamePrefix: DR.
NameSuffix:  
Credential: BCBA, LABA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6 MEADOWCREST RD
Address2:  
City: HOOKSETT
State: NH
PostalCode: 031062621
CountryCode: US
TelephoneNumber: 5082943322
FaxNumber:  
Practice Location
Address1: 33 TURNPIKE RD
Address2:  
City: SOUTHBOROUGH
State: MA
PostalCode: 017722108
CountryCode: US
TelephoneNumber: 5084811015
FaxNumber: 5089867180
Other Information
ProviderEnumerationDate: 11/11/2021
LastUpdateDate: 11/11/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/10/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103K00000X  Y Behavioral Health & Social Service ProvidersBehavioral Analyst 

No ID Information.


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