Provider Demographics
NPI:1891394318
Name:MACDONALD, SHARON MARIE (OTR/L, TVI)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:MARIE
Last Name:MACDONALD
Suffix:
Gender:F
Credentials:OTR/L, TVI
Other - Prefix:MRS
Other - First Name:SHARON
Other - Middle Name:
Other - Last Name:MACDONALD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTR/L, TVI
Mailing Address - Street 1:75 ABINGTON ST
Mailing Address - Street 2:
Mailing Address - City:HINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02043-4314
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:75 ABINGTON ST
Practice Address - Street 2:
Practice Address - City:HINGHAM
Practice Address - State:MA
Practice Address - Zip Code:02043-4314
Practice Address - Country:US
Practice Address - Phone:781-740-1808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-26
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8631225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty