Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 2033 | MA |
NPI | 1194787325 |
---|---|
Provider Name | Teresa Anne Rettman |
First Address | North Easton, MA 02356-1000 |
Second Address | North Easton, MA 02356-1000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2006 |
Last Update Date | 15/03/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0704822 | (05) | MA |
AA49825 | HARVARD PILGRIM (01) | MA |