Healthcare Provider Details

I. General information

NPI: 1124173679
Provider Name (Legal Business Name): AMY DUVAL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 04/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

460 AMHERST ST
NASHUA NH
03063-1220
US

IV. Provider business mailing address

386 RIMMON ST
MANCHESTER NH
03102-3715
US

V. Phone/Fax

Practice location:
  • Phone: 603-577-8400
  • Fax: 603-577-8405
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number1391
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: