Provider Demographics
NPI:1477603058
Name:BRACE, NANCY J (OT)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:J
Last Name:BRACE
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 ORCHARD ST
Mailing Address - Street 2:
Mailing Address - City:MARLBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01752-4326
Mailing Address - Country:US
Mailing Address - Phone:978-460-4924
Mailing Address - Fax:
Practice Address - Street 1:WESTBOROUGH STATE HOSPITAL
Practice Address - Street 2:288 LYMAN STREET
Practice Address - City:WESTBORO
Practice Address - State:MA
Practice Address - Zip Code:01581
Practice Address - Country:US
Practice Address - Phone:508-616-2286
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8762225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist