Provider Demographics
NPI:1255401873
Name:CONAWAY, MEREDITH A (MS, OTR L)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:A
Last Name:CONAWAY
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 1:806 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LACONIA
Mailing Address - State:NH
Mailing Address - Zip Code:03246-2603
Mailing Address - Country:US
Mailing Address - Phone:603-524-9090
Mailing Address - Fax:
Practice Address - Street 1:25 MAIN ST
Practice Address - Street 2:
Practice Address - City:HOLLIS
Practice Address - State:NH
Practice Address - Zip Code:03049-6544
Practice Address - Country:US
Practice Address - Phone:603-324-5997
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1781225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30413767Medicaid