Provider Demographics
NPI:1053917286
Name:HARADON, CHRISTINE DANIELLE (LMT)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:DANIELLE
Last Name:HARADON
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 1:43 RIDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:GILMANTON
Mailing Address - State:NH
Mailing Address - Zip Code:03237-5034
Mailing Address - Country:US
Mailing Address - Phone:603-219-7438
Mailing Address - Fax:
Practice Address - Street 1:37 SO. SPRING STREET
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-2433
Practice Address - Country:US
Practice Address - Phone:603-620-8690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-11
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH7935225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1073074878OtherVHA