Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 12109 | MA |
NPI | 1003366543 |
---|---|
Provider Name | Emma Gelinas |
First Address | East Freetown, MA 02717-1805 |
Second Address | East Freetown, MA 02717-1805 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/10/2016 |
Last Update Date | 08/10/2016 |