Healthcare Provider Details

I. General information

NPI: 1013194398
Provider Name (Legal Business Name): KATHI MINAHAN LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/29/2008
Last Update Date: 01/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 PARMENTER RD
LONDONDERRY NH
03053-3280
US

IV. Provider business mailing address

12 PARMENTER RD
LONDONDERRY NH
03053-3280
US

V. Phone/Fax

Practice location:
  • Phone: 603-231-3856
  • Fax:
Mailing address:
  • Phone: 603-231-3856
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175L00000X
TaxonomyHomeopath
License Number2833M
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: