Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 11936 | MA |
NPI | 1811581895 |
---|---|
Provider Name | Rachel Christine Menard |
First Address | Walpole, MA 02081-2821 |
Second Address | Walpole, MA 02081-4037 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2021 |
Last Update Date | 22/02/2021 |