Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 7683 | MA |
Y | 225XH1200X | Occupational Therapist - Hand | 7683 | MA |
NPI | 1194923177 |
---|---|
Provider Name | Kerstin Palm |
First Address | Boston, MA 02130-3446 |
Second Address | Boston, MA 02130-3446 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2007 |
Last Update Date | 11/07/2007 |