Provider Demographics
NPI:1427123264
Name:FRAUTON, NOELLE (OT)
Entity type:Individual
Prefix:
First Name:NOELLE
Middle Name:
Last Name:FRAUTON
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 DANIEL WEBSTER HWY
Mailing Address - Street 2:UNIT 1
Mailing Address - City:MERRIMACK
Mailing Address - State:NH
Mailing Address - Zip Code:03054
Mailing Address - Country:US
Mailing Address - Phone:603-424-1950
Mailing Address - Fax:603-424-4749
Practice Address - Street 1:380 DANIEL WEBSTER HWY
Practice Address - Street 2:UNIT 1
Practice Address - City:MERRIMACK
Practice Address - State:NH
Practice Address - Zip Code:03054-4169
Practice Address - Country:US
Practice Address - Phone:603-424-1950
Practice Address - Fax:603-424-4749
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1627174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH1627OtherLICENSE #
NH30412349Medicaid
NH30412349Medicaid