Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 8459 | MA |
NPI | 1003097247 |
---|---|
Provider Name | Ms. Adrienne Marie Wood |
First Address | Melrose, MA 02176-3940 |
Second Address | Woburn, MA 01801-4624 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2007 |
Last Update Date | 15/11/2007 |