Most Relevant Information
Provider Data
| NPI Number: | 1003527938 |
| Provider Name: | JENNIFER SHATTUCK |
| Entity Type: | Individual |
| Taxonomy Code: | 175T00000X |
| Specialty: | Peer Specialist |
| License Number: |
Most Important Dates
| Enumeration Date: | 12/12/2022 |
| Last Updated: | 12/12/2022 |
Provider Practice Location
401 CYPRESS ST
MANCHESTER
NH
031033699
Practice Location Phone/Fax
| Phone: | 6036684111 |
| Fax: |
Provider Mailing Location
2 WALL ST STE 100A
MANCHESTER
NH
031011518
Provider Mailing Phone/Fax
| Phone: | 6036684111 |
| Fax: |