Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 1370 | NH |
Y | 225X00000X | Occupational Therapist | 3137 | MA |
N | 225XE0001X | Environmental Modification | 1370 | NH |
N | 225XE0001X | Environmental Modification | 3137 | MA |
N | 225XG0600X | Occupational Therapist - Gerontology | 1370 | NH |
N | 225XG0600X | Occupational Therapist - Gerontology | 3137 | MA |
N | 2251H1300X | Human Factors | 1370 | NH |
N | 225XH1300X | Human Factors | 1370 | NH |
N | 2251H1300X | Human Factors | 3137 | MA |
N | 225XH1300X | Human Factors | 3137 | MA |
N | 225XL0004X | Low Vision | 1370 | NH |
N | 225XL0004X | Low Vision | 3137 | MA |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | 1370 | NH |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | 3137 | MA |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 1370 | NH |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 3137 | MA |
N | 225XR0403X | Driving and Community Mobility | 3137 | MA |
NPI | 1124647730 |
---|---|
Provider Name | Mrs. Diane Willette Walker |
First Address | Billerica, MA 01821-3013 |
Second Address | Billerica, MA 01821-3013 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2020 |
Last Update Date | 14/04/2020 |