Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 10366 | MA |
N | 225XE0001X | Environmental Modification | 10366 | MA |
N | 225XG0600X | Occupational Therapist - Gerontology | 10366 | MA |
N | 2251H1300X | Human Factors | 10366 | MA |
N | 225XH1300X | Human Factors | 10366 | MA |
N | 225XM0800X | Mental Health | 10366 | MA |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | 10366 | MA |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 10366 | MA |
N | 225XP0200X | Occupational Therapist - Pediatrics | 10366 | MA |
N | 225XR0403X | Driving and Community Mobility | 10366 | MA |
NPI | 1184975146 |
---|---|
Provider Name | Ms. Erika Lee Davis |
First Address | Cambridge, MA 02140-1801 |
Second Address | Cambridge, MA 02140-1801 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2012 |
Last Update Date | 30/09/2012 |