Provider Demographics
NPI:1497504757
Name:RICHARDS, JULIE MAE (LMT)
Entity type:Individual
Prefix:MS
First Name:JULIE
Middle Name:MAE
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1416
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NH
Mailing Address - Zip Code:03031-1416
Mailing Address - Country:US
Mailing Address - Phone:603-465-1655
Mailing Address - Fax:
Practice Address - Street 1:169 S RIVER RD UNIT 4
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6934
Practice Address - Country:US
Practice Address - Phone:603-465-1655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-17
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH5099M225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist