Individual
LAURA PSALEDAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
555 AUBURN ST, MANCHESTER, NH 03103-4803
(603) 623-8863
Mailing address
555 AUBURN ST, MANCHESTER, NH 03103-4803
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0851
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13Y007905NH01
ANTHEM NEW HAMPSHIRE
NH
01
—
4130062
MVP
NH
Enumeration date
01/25/2007
Last updated
04/28/2010
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