Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 2729 | MA |
NPI | 1023132891 |
---|---|
Provider Name | Shelly A Mccann |
First Address | Fall River, MA 02723-2718 |
Second Address | Fall River, MA 02720-5835 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2007 |
Last Update Date | 08/07/2007 |