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General NPI Number Information
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NPI Number | 1831338847
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Entity Type | Individual
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Provider Name | ABBEY LAINE THEROUX PMHNP
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Gender | Female
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Dates
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Enumeration Date | 02/13/2009
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Last Update Date | 04/15/2025
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Provider Practice Location Address
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Address Line | 276 NEWPORT RD STE 1-7
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City | NEW LONDON
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State | NH
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Zip | 03257-5468
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Country | US
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Telephone | 505-205-8941
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Fax |
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Provider Business Mailing Address
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Address Line | 58 BLUEBERRY LN
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City | NEW LONDON
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State | NH
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Zip | 03257-5511
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Country | US
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Telephone | 505-504-1166
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 281
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 078663-23
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License Number State | NH
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