Provider Demographics
NPI:1710027115
Name:STOCKBRIDGE, KRISTIN CLIFFORD (MS OTR/L)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:CLIFFORD
Last Name:STOCKBRIDGE
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25B ROBINSON RD
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NH
Mailing Address - Zip Code:03051-3129
Mailing Address - Country:US
Mailing Address - Phone:603-944-7981
Mailing Address - Fax:
Practice Address - Street 1:806 N MAIN ST
Practice Address - Street 2:
Practice Address - City:LACONIA
Practice Address - State:NH
Practice Address - Zip Code:03246-2603
Practice Address - Country:US
Practice Address - Phone:603-524-9090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1844225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH13Y010621NH01OtherANTHEM
NH798819OtherMVP