Healthcare Provider Details

I. General information

NPI: 1851214431
Provider Name (Legal Business Name): SAMANTHA LIN LOPEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 PERIMETER RD
NASHUA NH
03063-1301
US

IV. Provider business mailing address

555 CANAL ST APT 1307
MANCHESTER NH
03101-1521
US

V. Phone/Fax

Practice location:
  • Phone: 603-600-3201
  • Fax:
Mailing address:
  • Phone: 603-777-6290
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: