Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 7758 | MA |
NPI | 1053882977 |
---|---|
Provider Name | Ms. Melissa Irene Feldman |
First Address | Milton, MA 02186-1511 |
Second Address | Milton, MA 02186-1511 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/12/2018 |
Last Update Date | 17/12/2018 |