Healthcare Provider Details

I. General information

NPI: 1831338847
Provider Name (Legal Business Name): ABBEY LAINE THEROUX PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2009
Last Update Date: 04/15/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

276 NEWPORT RD STE 1-7
NEW LONDON NH
03257-5468
US

IV. Provider business mailing address

58 BLUEBERRY LN
NEW LONDON NH
03257-5511
US

V. Phone/Fax

Practice location:
  • Phone: 505-205-8941
  • Fax:
Mailing address:
  • Phone: 505-504-1166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number281
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number078663-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: