Provider Demographics
NPI:1982783098
Name:LOUBIER, JUDITH (PT)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:
Last Name:LOUBIER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:JUDITH
Other - Middle Name:
Other - Last Name:ILACQUA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CDP, CSA
Mailing Address - Street 1:360 ROUTE 101 STE 3B
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-5047
Mailing Address - Country:US
Mailing Address - Phone:603-801-1936
Mailing Address - Fax:844-491-0931
Practice Address - Street 1:360 ROUTE 101 STE 3B
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-5047
Practice Address - Country:US
Practice Address - Phone:603-801-1936
Practice Address - Fax:844-491-0931
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2019-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374U00000X, 376J00000X, 171M00000X, 376K00000X, 372500000X, 372600000X, 3747A0650X
NH844225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No374U00000XNursing Service Related ProvidersHome Health Aide
No376J00000XNursing Service Related ProvidersHomemaker
No376K00000XNursing Service Related ProvidersNurse's Aide
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30393889Medicaid