| NPI | 1205228111 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE CROAK Occupational Therapist 781-609-2514 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist Pediatrics |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist |
| Enumeration Date | 2015-03-02 |
| Last Update Date | 2015-03-02 |