Provider Demographics
NPI:1295757276
Name:STENSLIE, CRAIG E (PHD)
Entity type:Individual
Prefix:
First Name:CRAIG
Middle Name:E
Last Name:STENSLIE
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 1:90 WASHINGTON ST
Mailing Address - Street 2:SUITE 304
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-3744
Mailing Address - Country:US
Mailing Address - Phone:603-749-0992
Mailing Address - Fax:
Practice Address - Street 1:90 WASHINGTON ST
Practice Address - Street 2:SUITE 304
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-3744
Practice Address - Country:US
Practice Address - Phone:603-749-0992
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH355103G00000X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30002739Medicaid
NH30002739Medicaid