Makina Itchkavich-Levasseur, MS, ATC, LAT

Individual provider Active NPI Athletic Trainer · Rindge, NH

NPI 1003422809 · NPPES record last updated Sep 17, 2020

Key facts

NPI
1003422809
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
0686 (NH)
Practice address
40 University Dr
Rindge, NH 03461-5045
Phone
(603) 899-1142
NPI assigned
Sep 17, 2020
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
0686NHMDAddiction (Substance Use Disorder) Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 0686 NH Yes

Addresses

Primary practice location

40 University Dr
Rindge, NH 03461-5045

Mailing address

223 Bancroft Rd
Rindge, NH 03461-5906
Phone (603) 630-1166

Other providers in Rindge, NH

All providers in Rindge, NH · Athletic Trainer in New Hampshire

Sources for this page

Verify at the official NPI Registry.