Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 1661 | MA |
N | 224Z00000X | Occupational Therapy Assistant | OTA00072 | RI |
NPI | 1003091299 |
---|---|
Provider Name | Mrs. Alice C Angelini |
First Address | Somerset, MA 02726-2642 |
Second Address | Somerset, MA 02726-2642 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/01/2008 |
Last Update Date | 12/01/2008 |