Provider Demographics
NPI:1194817940
Name:TAFT, MICHELE A (OTR L)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:A
Last Name:TAFT
Suffix:
Gender:F
Credentials:OTR L
Other - Prefix:
Other - First Name:MICHELE
Other - Middle Name:A
Other - Last Name:IORIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:630 PLANTATION ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605
Mailing Address - Country:US
Mailing Address - Phone:508-368-3140
Mailing Address - Fax:508-368-3143
Practice Address - Street 1:123 SUMMER ST
Practice Address - Street 2:SUITE 320
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605
Practice Address - Country:US
Practice Address - Phone:508-368-3140
Practice Address - Fax:508-368-3143
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3254225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OT0064OtherBLUE CROSS
042472266OtherHEALTHCARE VALUE MANAGEME
43204OtherFALLON COMMUNITY HEALTH P
7642622OtherAETNA US HEALTHCARE
784238OtherMVP HEALTH CARE
AA4053OtherHARVARD PILGRIM HEALTHCAR
042472266OtherPRIVATE HEALTHCARE SYSTEM
2779432OtherCIGNA HEALTH PLAN
670001275OtherRAILROAD MEDICARE
MA0359343Medicaid
042472266OtherTHREE RIVERS
Y68450Medicare ID - Type UnspecifiedPART B
7642622OtherAETNA US HEALTHCARE