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General NPI Number Information
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NPI Number | 1346563467
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Entity Type | Individual
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Provider Name | LOUISE HUMPHREY-ARRUDA LAT, ATC, LMT, BCMTB
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Gender | Female
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Dates
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Enumeration Date | 03/03/2010
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Last Update Date | 11/12/2024
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Provider Practice Location Address
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Address Line | 300 INDUSTRIAL WAY
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City | TIVERTON
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State | RI
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Zip | 02878-3133
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Country | US
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Telephone | 401-486-7379
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Fax |
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Provider Business Mailing Address
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Address Line | 3771 OLD MAIN RD
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City | TIVERTON
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State | RI
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Zip | 02878-4845
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Country | US
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Telephone | 401-486-7379
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT00283
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License Number State | RI
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT00968
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License Number State | RI
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