Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 8615 | MA |
NPI | 1801273065 |
---|---|
Provider Name | Ms. Marie Gertrude Chalifour |
First Address | Sunderland, MA 01375-9313 |
Second Address | Turners Falls, MA 01376-1830 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2015 |
Last Update Date | 27/04/2015 |