Provider Demographics
NPI:1770192866
Name:SPENCE-BERTHIAUME, PAIGE BURWELL (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:PAIGE
Middle Name:BURWELL
Last Name:SPENCE-BERTHIAUME
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 DONOVAN RD
Mailing Address - Street 2:
Mailing Address - City:NORTH BROOKFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01535-1329
Mailing Address - Country:US
Mailing Address - Phone:774-641-1199
Mailing Address - Fax:
Practice Address - Street 1:52 BOYDEN RD UNIT 209
Practice Address - Street 2:
Practice Address - City:HOLDEN
Practice Address - State:MA
Practice Address - Zip Code:01520-2592
Practice Address - Country:US
Practice Address - Phone:508-963-6582
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-24
Last Update Date:2020-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8944225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist