Provider Demographics
NPI:1134513542
Name:BERCIER, CELIA R
Entity Type:Individual
Prefix:MRS
First Name:CELIA
Middle Name:R
Last Name:BERCIER
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:SALLY
Other - Middle Name:
Other - Last Name:BERCIER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:COTA/L
Mailing Address - Street 1:7 BOXWOOD LN
Mailing Address - Street 2:
Mailing Address - City:DARTMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02747-5803
Mailing Address - Country:US
Mailing Address - Phone:508-525-0833
Mailing Address - Fax:
Practice Address - Street 1:863 HATHAWAY RD
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-1916
Practice Address - Country:US
Practice Address - Phone:508-996-6763
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-24
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2569224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant