Provider Demographics
NPI:1184834590
Name:MCGUINESS, COLLEEN ELLEN (OTR)
Entity Type:Individual
Prefix:MRS
First Name:COLLEEN
Middle Name:ELLEN
Last Name:MCGUINESS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 PAINE ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-3337
Mailing Address - Country:US
Mailing Address - Phone:508-792-2373
Mailing Address - Fax:
Practice Address - Street 1:80 DEACONESS RD
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-4113
Practice Address - Country:US
Practice Address - Phone:978-369-5151
Practice Address - Fax:978-369-0722
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8557225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist