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Individual

BRENDA GAFFNEY LARKIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OT/L

Contact information

Practice address
555 AUBURN ST, MANCHESTER, NH 03103-4803
(603) 623-8863
Mailing address
396 N STARK HWY, WEARE, NH 03281-4213

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0821
NH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1305062Y0NH01
ANTHEM NH PROVIDER ID
NH
01
373087
MVP HEALTCARE ID
NH
Enumeration date
10/17/2006
Last updated
07/08/2007
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