Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 3245 | MA |
NPI | 1013680263 |
---|---|
Provider Name | Mrs. Christina Beaulieu |
First Address | Westfield, MA 01085-1873 |
Second Address | Westfield, MA 01085-1873 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2021 |
Last Update Date | 25/07/2021 |