Provider Demographics
NPI:1922294941
Name:EMERSON, JOAN PETERSON (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:PETERSON
Last Name:EMERSON
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 1:501 MAHAR HIGHWAY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:501 JOHN MAHAR HWY
Practice Address - Street 2:SUITE 200
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-6599
Practice Address - Country:US
Practice Address - Phone:781-843-2733
Practice Address - Fax:781-843-2805
Is Sole Proprietor?:No
Enumeration Date:2007-09-24
Last Update Date:2007-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8409225X00000X
RIOT00932225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist