MEDICARE: SAMANTHA RAE LANOUETTE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	3701	NH

General Provider Information

NPI Number	:	1699658872
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMANTHA RAE LANOUETTE

Provider Business Mailing Address
First Line	:	7 LINLEW DR
Second Line	:
City	:	DERRY
State	:	NH
Zip	:	03038-3035
Country	:	US
Telephone Number	:	603-450-9145
Fax Number	:	603-450-9145

Provider Business Practice Location Address
First Line	:	63 RANGE RD STE 300
Second Line	:
City	:	WINDHAM
State	:	NH
Zip	:	03087-2098
Country	:	US
Telephone Number	:	603-450-9145
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2025
Last Update Date	:	07/28/2025

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Directions to “ SAMANTHA RAE LANOUETTE ” Practice Location

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