Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 8905 | MA |
NPI | 1275668030 |
---|---|
Provider Name | Mrs. Joanna Marie Hollywood |
First Address | Weymouth, MA 02190-1326 |
Second Address | Boston, MA 02114-3117 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2007 |
Last Update Date | 27/01/2010 |