Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 5837 | MA |
NPI | 1205460763 |
---|---|
Provider Name | Susan Venezia |
First Address | Framingham, MA 01701-3583 |
Second Address | Milford, MA 01757-5501 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/02/2020 |
Last Update Date | 24/02/2020 |