Provider Demographics
NPI:1689744229
Name:THEROUX-JETTE, LUCINDA MARIE (PHD, OT/L, LAC)
Entity Type:Individual
Prefix:DR
First Name:LUCINDA
Middle Name:MARIE
Last Name:THEROUX-JETTE
Suffix:
Gender:F
Credentials:PHD, OT/L, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 MAIN ST STE 310
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060-2720
Mailing Address - Country:US
Mailing Address - Phone:603-231-2478
Mailing Address - Fax:603-598-6740
Practice Address - Street 1:60 MAIN ST STE 310
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-2720
Practice Address - Country:US
Practice Address - Phone:603-231-2478
Practice Address - Fax:603-598-6740
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2017-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH070171100000X
NH898225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist