Provider Demographics
NPI:1669549390
Name:O'MALEY, JANE ELIZABETH (OTR/L, LIC AC)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:ELIZABETH
Last Name:O'MALEY
Suffix:
Gender:F
Credentials:OTR/L, LIC AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:182 GRANITE ST
Mailing Address - Street 2:
Mailing Address - City:ROCKPORT
Mailing Address - State:MA
Mailing Address - Zip Code:01966-1274
Mailing Address - Country:US
Mailing Address - Phone:978-546-0266
Mailing Address - Fax:
Practice Address - Street 1:182 GRANITE ST
Practice Address - Street 2:
Practice Address - City:ROCKPORT
Practice Address - State:MA
Practice Address - Zip Code:01966-1274
Practice Address - Country:US
Practice Address - Phone:978-546-0266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA454171100000X
MA1900225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No171100000XOther Service ProvidersAcupuncturist