Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 2 | MA |
N | 225XL0004X | Low Vision | 2 | MA |
N | 225XM0800X | Mental Health | 2 | MA |
NPI | 1679715171 |
---|---|
Provider Name | Diane Lois Akula |
First Address | Cambridge, MA 02138-3317 |
Second Address | Cambridge, MA 02138-3317 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2009 |
Last Update Date | 30/03/2009 |