Provider Demographics
NPI:1407030091
Name:MCCARTHY, PATRICIA ANN (OTR/L)
Entity Type:Individual
Prefix:MISS
First Name:PATRICIA
Middle Name:ANN
Last Name:MCCARTHY
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 1:11 COLUMBIA RD
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01880-3339
Mailing Address - Country:US
Mailing Address - Phone:978-302-0802
Mailing Address - Fax:
Practice Address - Street 1:11 COLUMBIA RD
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:MA
Practice Address - Zip Code:01880-3339
Practice Address - Country:US
Practice Address - Phone:978-302-0802
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-19
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8130172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker