Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 2823 | NH |
N | 225XP0200X | Occupational Therapist - Pediatrics | 2823 | NH |
NPI | 1063980365 |
---|---|
Provider Name | Erinn Madden |
First Address | Merrimack, NH 03054-4437 |
Second Address | Manchester, NH 03109-5607 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/11/2018 |
Last Update Date | 05/11/2018 |