Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 3681 | MA |
NPI | 1023420023 |
---|---|
Provider Name | Devon Barry |
First Address | Lowell, MA 01851-2405 |
Second Address | Lowell, MA 01851-2405 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2014 |
Last Update Date | 24/05/2014 |