Provider Demographics
NPI:1720425820
Name:NORTON, MILDRED MARY (OTR/L)
Entity Type:Individual
Prefix:MISS
First Name:MILDRED
Middle Name:MARY
Last Name:NORTON
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 1:19 OBERY ST
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-2129
Mailing Address - Country:US
Mailing Address - Phone:508-747-4790
Mailing Address - Fax:508-746-3880
Practice Address - Street 1:19 OBERY ST
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-2129
Practice Address - Country:US
Practice Address - Phone:508-747-4790
Practice Address - Fax:508-746-3880
Is Sole Proprietor?:No
Enumeration Date:2013-05-29
Last Update Date:2013-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7921225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist