Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 9520 | MA |
NPI | 1922509496 |
---|---|
Provider Name | Eri Sugiyama Purdon |
First Address | Somerville, MA 02143-1408 |
Second Address | Somerville, MA 02143-1408 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2018 |
Last Update Date | 21/02/2018 |