Provider Demographics
NPI:1932419850
Name:GOYETTE, MOUNA (DPT)
Entity type:Individual
Prefix:
First Name:MOUNA
Middle Name:
Last Name:GOYETTE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 DUNDEE RD
Mailing Address - Street 2:
Mailing Address - City:INTERVALE
Mailing Address - State:NH
Mailing Address - Zip Code:03845-6148
Mailing Address - Country:US
Mailing Address - Phone:781-820-4884
Mailing Address - Fax:
Practice Address - Street 1:15 US ROUTE 302
Practice Address - Street 2:SUITE 2
Practice Address - City:GLEN
Practice Address - State:NH
Practice Address - Zip Code:03838
Practice Address - Country:US
Practice Address - Phone:603-383-7009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-13
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH35852251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic