Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 10595 | MA |
NPI | 1003175407 |
---|---|
Provider Name | Teresa Czepiel |
First Address | Ludlow, MA 01056-1436 |
Second Address | West Roxbury, MA 02132-4927 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2012 |
Last Update Date | 05/04/2016 |