Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 11796 | MA |
NPI | 1003390808 |
---|---|
Provider Name | Bridget Mary Hughes |
First Address | Agawam, MA 01001-1367 |
Second Address | Agawam, MA 01001-1367 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/09/2018 |
Last Update Date | 18/09/2018 |