Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 3172 | NH |
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 9197 | MA |
NPI | 1144895061 |
---|---|
Provider Name | Rebecca Michelle Ellison |
First Address | Hudson, MA 01749-3106 |
Second Address | Salem, NH 03079-4859 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2021 |
Last Update Date | 24/05/2021 |