Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 3597 | MA |
NPI | 1215391685 |
---|---|
Provider Name | Todd M Paquette |
First Address | Hyannis, MA 02601-4528 |
Second Address | Hyannis, MA 02601-4528 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2016 |
Last Update Date | 11/04/2016 |