Healthcare Provider Details

I. General information

NPI: 1801325006
Provider Name (Legal Business Name): ABIGAIL LIBBY FARNIOK MS, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2017
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 BALDWIN ST
FRANKLIN NH
03235-2000
US

IV. Provider business mailing address

39 BRECKENRIDGE WAY UNIT 6
LACONIA NH
03246-4020
US

V. Phone/Fax

Practice location:
  • Phone: 603-934-2541
  • Fax:
Mailing address:
  • Phone: 763-688-0415
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number2588
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: