# NEW LIGHT THERAPY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104110840
- **Authorized official:** ERIN VAILLANCOURT D.P.T. (PHYSICAL THERAPIST)
- **Authorized official phone:** (775) 235-8809

## Contact information

- **Practice address:** 2869 ESAW ST, MINDEN, NV 89423-9059
- **Practice address phone:** (775) 235-8809
- **Practice address fax:** (775) 420-4675
- **Mailing address:** 1329 HWY 395, SUITE 10-274, GARDNERVILLE, NV 89410
- **Mailing address phone:** (775) 235-8809
- **Mailing address fax:** (775) 420-4675

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | — |
| 225100000X | Physical Therapist | — | — | — |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |
| 235Z00000X | Speech-Language Pathologist | — | NULL | — |
| 235Z00000X | Speech-Language Pathologist | — | — | — |
| 320700000X | Physical Disabilities Residential Treatment Facility | NV20101224552 | NV | Yes |

## Other

- **Enumeration date:** 05/28/2011
- **Last updated:** 06/18/2024