Provider Demographics
NPI:1073815338
Name:GUERTIN, JUDITH FAYE (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:FAYE
Last Name:GUERTIN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94 CLOVER HILL CIR
Mailing Address - Street 2:
Mailing Address - City:TYNGSBORO
Mailing Address - State:MA
Mailing Address - Zip Code:01879-2525
Mailing Address - Country:US
Mailing Address - Phone:978-649-7733
Mailing Address - Fax:
Practice Address - Street 1:94 CLOVER HILL CIR
Practice Address - Street 2:
Practice Address - City:TYNGSBORO
Practice Address - State:MA
Practice Address - Zip Code:01879-2525
Practice Address - Country:US
Practice Address - Phone:978-649-7733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-18
Last Update Date:2010-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA676225X00000X
NH1101225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist