Provider Demographics
NPI:1174779474
Name:PERRON, NATHAN CLAUDE DAVID (PHD)
Entity type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:CLAUDE DAVID
Last Name:PERRON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 OPERA HOUSE SQ UNIT 25
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:NH
Mailing Address - Zip Code:03743-5419
Mailing Address - Country:US
Mailing Address - Phone:603-504-6140
Mailing Address - Fax:603-764-7362
Practice Address - Street 1:24 OPERA HOUSE SQ UNIT 25
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:NH
Practice Address - Zip Code:03743-5419
Practice Address - Country:US
Practice Address - Phone:603-504-6140
Practice Address - Fax:603-764-7362
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-18
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180006967101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional