Provider Demographics
NPI:1750683520
Name:MOYNIHAN, ALLISON K (MS OTR/L)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:K
Last Name:MOYNIHAN
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 1:170 BARTON HILL RD
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:MA
Mailing Address - Zip Code:01226-2005
Mailing Address - Country:US
Mailing Address - Phone:413-446-3069
Mailing Address - Fax:
Practice Address - Street 1:25 ADAMS RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSTOWN
Practice Address - State:MA
Practice Address - Zip Code:01267-2928
Practice Address - Country:US
Practice Address - Phone:413-458-2111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-29
Last Update Date:2010-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10222174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist