Provider Demographics
NPI:1265651640
Name:AZOFF, NICKI TRAUTE (OT)
Entity Type:Individual
Prefix:MRS
First Name:NICKI
Middle Name:TRAUTE
Last Name:AZOFF
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5 SAXONY DR
Mailing Address - Street 2:
Mailing Address - City:SUDBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01776-2123
Mailing Address - Country:US
Mailing Address - Phone:978-443-3537
Mailing Address - Fax:978-261-5147
Practice Address - Street 1:61 NICHOLAS RD
Practice Address - Street 2:SUITE 10A
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01701-3498
Practice Address - Country:US
Practice Address - Phone:508-877-5525
Practice Address - Fax:508-877-6997
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA2174225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics