Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 4254 | MA |
NPI | 1023522612 |
---|---|
Provider Name | Mary Margaret Daly |
First Address | Weymouth, MA 02190-1818 |
Second Address | Weymouth, MA 02190-1818 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2017 |
Last Update Date | 20/11/2017 |