Healthcare Provider Details

I. General information

NPI: 1972093771
Provider Name (Legal Business Name): AMY RAE COUTU LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2018
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 PLEASANT ST
CLAREMONT NH
03743-2610
US

IV. Provider business mailing address

4 SIMS ST
CLAREMONT NH
03743-5606
US

V. Phone/Fax

Practice location:
  • Phone: 603-306-1365
  • Fax:
Mailing address:
  • Phone: 603-306-1365
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number8345
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: