Provider Demographics
NPI:1356648802
Name:MESSNER, EMILY (OTR/L)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:MESSNER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:479 N HARLEM AVE
Mailing Address - Street 2:#1422
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60301-6401
Mailing Address - Country:US
Mailing Address - Phone:708-289-5838
Mailing Address - Fax:
Practice Address - Street 1:27 HAMMOND ST
Practice Address - Street 2:APT. A
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02451-3684
Practice Address - Country:US
Practice Address - Phone:708-289-5838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-18
Last Update Date:2011-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10242225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist