Healthcare Provider Details

I. General information

NPI: 1740682186
Provider Name (Legal Business Name): AMANDA AVERACK LANGER OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2014
Last Update Date: 05/02/2025
Certification Date: 05/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

522 AMHERST ST STE 23
NASHUA NH
03063-1019
US

IV. Provider business mailing address

3 JOYCE LN
STRATHAM NH
03885-2117
US

V. Phone/Fax

Practice location:
  • Phone: 603-484-4070
  • Fax:
Mailing address:
  • Phone: 203-980-3651
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOTL12256
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number2659
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: