Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 3758 | MA |
NPI | 1013517069 |
---|---|
Provider Name | Kelsey Rena Roy |
First Address | Attleboro, MA 02703-5549 |
Second Address | North Attleboro, MA 02760-1634 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/10/2020 |
Last Update Date | 29/10/2020 |