Provider Demographics
NPI:1245397249
Name:HERLIHY, LYNNMARIE (MS, OTR)
Entity Type:Individual
Prefix:MISS
First Name:LYNNMARIE
Middle Name:
Last Name:HERLIHY
Suffix:
Gender:F
Credentials:MS, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 WASHINGTON ST
Mailing Address - Street 2:APT. 2
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-2612
Mailing Address - Country:US
Mailing Address - Phone:617-783-2126
Mailing Address - Fax:
Practice Address - Street 1:444 WASHINGTON ST
Practice Address - Street 2:APT. 2
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135-2612
Practice Address - Country:US
Practice Address - Phone:617-783-2126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6759225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist