Provider Demographics
NPI:1053904888
Name:ZELLER, LYDIA (NCSP)
Entity type:Individual
Prefix:
First Name:LYDIA
Middle Name:
Last Name:ZELLER
Suffix:
Gender:F
Credentials:NCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:806 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LACONIA
Mailing Address - State:NH
Mailing Address - Zip Code:03246-2603
Mailing Address - Country:US
Mailing Address - Phone:603-524-9090
Mailing Address - Fax:603-542-1497
Practice Address - Street 1:29 SCHOOL RD
Practice Address - Street 2:
Practice Address - City:LEMPSTER
Practice Address - State:NH
Practice Address - Zip Code:03605-3500
Practice Address - Country:US
Practice Address - Phone:603-863-2420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-12
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH129403103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist