Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 11877 | MA |
NPI | 1093176042 |
---|---|
Provider Name | Lauren Prokop Pawlowski |
First Address | Boston, MA 02111-1552 |
Second Address | Boston, MA 02111-1552 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2016 |
Last Update Date | 17/03/2016 |