Provider Demographics
NPI:1619269933
Name:FEENEY, EDWARD (OT/L)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:
Last Name:FEENEY
Suffix:
Gender:M
Credentials:OT/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 ARLINGTON ST
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01501-2637
Mailing Address - Country:US
Mailing Address - Phone:508-798-6699
Mailing Address - Fax:508-798-7011
Practice Address - Street 1:13 ARLINGTON ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:MA
Practice Address - Zip Code:01501-2637
Practice Address - Country:US
Practice Address - Phone:508-798-6699
Practice Address - Fax:508-798-7011
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-04
Last Update Date:2011-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6029225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics