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Individual

KRISTEN DOUGLASS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OT

Contact information

Practice address
144 CANAL ST, NASHUA, NH 03064-2886
(603) 882-6333
(603) 459-2795
Mailing address
144 CANAL ST, NASHUA, NH 03064-2886
(603) 459-2795
(603) 459-2783

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1187
NH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
020377315
COMM TAX ID
NH
01
13Y002968NH01
ANTHEM BCBS
01
272746
CIGNA
NH
01
561822
AETNA
NH
01
626514
HARVARD PILGRIM
NH
01
761242
TUFTS
NH
05
99560056
NH
Enumeration date
12/06/2006
Last updated
08/27/2019
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