Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XP0200X | Occupational Therapist - Pediatrics | 13142 | MA |
NPI | 1063073864 |
---|---|
Provider Name | Debora Monteiro Magalhaes |
First Address | Ashland, MA 01721 |
Second Address | Ashland, MA 01721 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2019 |
Last Update Date | 22/11/2021 |