Provider Demographics
NPI:1568749190
Name:POOLE, CLAIRE RYAN (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:CLAIRE
Middle Name:RYAN
Last Name:POOLE
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 1:91 WOODLAWN CIR
Mailing Address - Street 2:
Mailing Address - City:MARSHFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02050-3509
Mailing Address - Country:US
Mailing Address - Phone:774-283-1258
Mailing Address - Fax:
Practice Address - Street 1:99 LONGWATER CIR
Practice Address - Street 2:
Practice Address - City:NORWELL
Practice Address - State:MA
Practice Address - Zip Code:02061-1642
Practice Address - Country:US
Practice Address - Phone:781-421-3771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-10
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4958225X00000X
TX114442225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist