Provider Demographics
NPI:1427207125
Name:LAGERVAL, ABBY (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:ABBY
Middle Name:
Last Name:LAGERVAL
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 1:1 PELAQUIN DR
Mailing Address - Street 2:
Mailing Address - City:EAST BRIDGEWATER
Mailing Address - State:MA
Mailing Address - Zip Code:02333-1672
Mailing Address - Country:US
Mailing Address - Phone:508-942-9373
Mailing Address - Fax:
Practice Address - Street 1:55 SUMMER ST
Practice Address - Street 2:
Practice Address - City:REHOBOTH
Practice Address - State:MA
Practice Address - Zip Code:02769-2221
Practice Address - Country:US
Practice Address - Phone:508-252-5814
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-17
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9133225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist