Provider Demographics
NPI:1407095771
Name:METROWEST OCCUPATIONAL THERAPY
Entity Type:Organization
Organization Name:METROWEST OCCUPATIONAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KATINA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAWDIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-877-5525
Mailing Address - Street 1:475 FRANKLIN ST
Mailing Address - Street 2:201
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-6264
Mailing Address - Country:US
Mailing Address - Phone:508-877-5525
Mailing Address - Fax:
Practice Address - Street 1:61 BROWN ST
Practice Address - Street 2:
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02453-3915
Practice Address - Country:US
Practice Address - Phone:781-650-6782
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-11
Last Update Date:2009-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3863302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization