Provider Demographics
NPI:1306581814
Name:DANEAU, MELISSA LYNN (LMT)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:LYNN
Last Name:DANEAU
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 1:20 MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:NH
Mailing Address - Zip Code:03032-3949
Mailing Address - Country:US
Mailing Address - Phone:603-765-6815
Mailing Address - Fax:
Practice Address - Street 1:505 W HOLLIS ST STE 205
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03062-1387
Practice Address - Country:US
Practice Address - Phone:743-460-3595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-29
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH7982225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist