Healthcare Provider Details

I. General information

NPI: 1922465673
Provider Name (Legal Business Name): KAITLYN LEFEBVRE OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2016
Last Update Date: 10/06/2020
Certification Date: 10/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 MAPLE AVE
CLAREMONT NH
03743-2832
US

IV. Provider business mailing address

165 BROAD ST
CLAREMONT NH
03743-3619
US

V. Phone/Fax

Practice location:
  • Phone: 603-543-4200
  • Fax:
Mailing address:
  • Phone: 603-543-4200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number2227
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number2227
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: