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1669833356 NPI number — ALICIA ROBIN POUSSARD MS, OTR/L

NPI Number: 1669833356
Health Care Provider/Practitioner: ALICIA ROBIN POUSSARD MS, OTR/L

Information about “1669833356” NPI (ALICIA ROBIN POUSSARD MS, OTR/L) exists in 1669833356 in HTML format HTML  |  1669833356 in plain Text format TXT  |  1669833356 in PDF (Portable Document Format) PDF  |  1669833356 in an XML format XML  formats.

NPI Number : 1669833356 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1669833356",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "POUSSARD",
    "FirstName": "ALICIA",
    "MiddleName": "ROBIN",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "MS, OTR/L",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "PETROUS",
    "OtherFirstName": "ALICIA",
    "OtherMiddleName": "ROBIN",
    "OtherNamePrefix": "MS.",
    "OtherNameSuffix": null,
    "OtherCredential": "MS, OTR/L",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "70 BUTLER ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SALEM",
    "MailingAddressStateName": "NH",
    "MailingAddressPostalCode": "03079-5802",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "603-893-2900",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "70 BUTLER ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SALEM",
    "PracticeLocationAddressStateName": "NH",
    "PracticeLocationAddressPostalCode": "03079-5802",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "603-893-2900",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "03/09/2016",
    "LastUpdateDate": "08/30/2017",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "225X00000X",
          "TaxonomyName": "Occupational Therapist",
          "LicenseNumber": "10863",
          "LicenseNumberStateCode": "MA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "225X00000X",
          "TaxonomyName": "Occupational Therapist",
          "LicenseNumber": "2321",
          "LicenseNumberStateCode": "NH",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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