Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 836 | MA |
NPI | 1063533099 |
---|---|
Provider Name | Ms. Frances Marie Bruen |
First Address | Worcester, MA 01606-1337 |
Second Address | Worcester, MA 01610-2177 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2007 |
Last Update Date | 08/07/2007 |