Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 13721 | MA |
NPI | 1093302556 |
---|---|
Provider Name | Leah Tinkham |
First Address | Somerville, MA 02144-2654 |
Second Address | Methuen, MA 01844-5870 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/12/2020 |
Last Update Date | 30/12/2020 |