Provider Demographics
NPI:1447643150
Name:LESSARD, MOLLY (LMT)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:
Last Name:LESSARD
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 1:12 PORTWALK PL
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-4086
Mailing Address - Country:US
Mailing Address - Phone:603-431-4200
Mailing Address - Fax:
Practice Address - Street 1:12 PORTWALK PL
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-4086
Practice Address - Country:US
Practice Address - Phone:603-431-4200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-05
Last Update Date:2015-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3762M225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist