Provider Demographics
NPI:1306199187
Name:HOSMER, IRENE T (MOT)
Entity Type:Individual
Prefix:MS
First Name:IRENE
Middle Name:T
Last Name:HOSMER
Suffix:
Gender:F
Credentials:MOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:495 SOUTH STREET
Mailing Address - Street 2:
Mailing Address - City:BELCHERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:01007-9607
Mailing Address - Country:US
Mailing Address - Phone:413-283-2230
Mailing Address - Fax:413-547-6145
Practice Address - Street 1:495 SOUTH ST
Practice Address - Street 2:
Practice Address - City:BELCHERTOWN
Practice Address - State:MA
Practice Address - Zip Code:01007-9607
Practice Address - Country:US
Practice Address - Phone:413-283-2230
Practice Address - Fax:413-547-6145
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-18
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9684225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist