Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 8846 | MA |
NPI | 1003096660 |
---|---|
Provider Name | Stacy Aileen Meulenaere |
First Address | Worcester, MA 01605-2138 |
Second Address | Worcester, MA 01605-2138 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/11/2007 |
Last Update Date | 08/07/2009 |