Lisa Marie Langlois, OTR

Key facts

NPI

1134895618

Entity type

Individual (NPI type 1)

Primary specialty

Pediatric Occupational Therapist 225XP0200X

License

1241 (NH)

Practice address

122 NH Route 12a Unit 2
Langdon, NH 03602-8263

Phone

(603) 835-7109

NPI assigned

Aug 17, 2021

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

State licenses

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 17, 2021.

{
    "created_epoch": "1629158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629158400000",
    "number": "1134895618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 NH ROUTE 12A UNIT 2",
            "city": "LANGDON",
            "state": "NH",
            "postal_code": "036028263",
            "telephone_number": "603-835-7109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 NH ROUTE 12A UNIT 2",
            "city": "LANGDON",
            "state": "NH",
            "postal_code": "036028263",
            "telephone_number": "603-835-7109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANGLOIS",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-17",
        "last_updated": "2021-08-17",
        "certification_date": "2021-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NH",
            "license": "1241",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "020269789",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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All providers in Langdon, NH · Pediatric Occupational Therapist in New Hampshire