Provider Demographics
NPI:1114323623
Name:AVIMOR HOROVITZ, RONI RACHEL (MOT, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:RONI
Middle Name:RACHEL
Last Name:AVIMOR HOROVITZ
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 WADSWORTH ST APT 26D
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02142-1355
Mailing Address - Country:US
Mailing Address - Phone:617-834-8273
Mailing Address - Fax:
Practice Address - Street 1:60 WADSWORTH ST APT 26D
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02142-1355
Practice Address - Country:US
Practice Address - Phone:617-834-8273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-10
Last Update Date:2014-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA11348225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics