Provider Demographics
NPI:1023391836
Name:VOSE, KRISTA MARIE (MS OT/L)
Entity type:Individual
Prefix:MS
First Name:KRISTA
Middle Name:MARIE
Last Name:VOSE
Suffix:
Gender:F
Credentials:MS OT/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:474 WEST ST
Mailing Address - Street 2:
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431-2453
Mailing Address - Country:US
Mailing Address - Phone:603-352-7803
Mailing Address - Fax:603-358-6711
Practice Address - Street 1:474 WEST ST
Practice Address - Street 2:
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431-2453
Practice Address - Country:US
Practice Address - Phone:603-352-7803
Practice Address - Fax:603-358-6711
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-28
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0834225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist