Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 707 | MA |
NPI | 1114025863 |
---|---|
Provider Name | Elaine Lacroix |
First Address | Boston, MA 02109-4806 |
Second Address | Boston, MA 02215-3904 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 07/04/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0014459 | NEIGHBORHOOD HEALTH PLAN (01) | MA |
0318566 | (05) | MA |
0T0074 | BLUE CROSS (01) | MA |
B501027 | CIGNA (01) | MA |
S86080 | (02) | MA |