Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 10437 | MA |
NPI | 1043568843 |
---|---|
Provider Name | Amanda Elizabeth Alboth-Weinburg |
First Address | Lowell, MA 01852-4931 |
Second Address | Lowell, MA 01852-4931 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/08/2012 |
Last Update Date | 27/08/2012 |