Provider Demographics
NPI:1497987903
Name:TONTINI- L'HEUREUX, ELIZABETH VAGNINI (MS, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:VAGNINI
Last Name:TONTINI- L'HEUREUX
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607 NORTH AVE
Mailing Address - Street 2:#14
Mailing Address - City:WAKEFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01880-1322
Mailing Address - Country:US
Mailing Address - Phone:781-245-4446
Mailing Address - Fax:781-245-5505
Practice Address - Street 1:607 NORTH AVE
Practice Address - Street 2:#14
Practice Address - City:WAKEFIELD
Practice Address - State:MA
Practice Address - Zip Code:01880-1322
Practice Address - Country:US
Practice Address - Phone:781-245-4446
Practice Address - Fax:781-245-5505
Is Sole Proprietor?:No
Enumeration Date:2009-08-17
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10702225X00000X
CT003391225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist