Provider Demographics
NPI:1255411146
Name:HARMON, DOREEN LESLIE (OTR)
Entity type:Individual
Prefix:
First Name:DOREEN
Middle Name:LESLIE
Last Name:HARMON
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:718 LUCAS RD
Mailing Address - Street 2:
Mailing Address - City:LONDONDERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03053-2157
Mailing Address - Country:US
Mailing Address - Phone:603-434-3960
Mailing Address - Fax:
Practice Address - Street 1:718 LUCAS RD
Practice Address - Street 2:
Practice Address - City:LONDONDERRY
Practice Address - State:NH
Practice Address - Zip Code:03053-2157
Practice Address - Country:US
Practice Address - Phone:603-434-3960
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH835225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30413021Medicaid
NHKIRE6047Medicare ID - Type Unspecified