Provider Demographics
NPI:1811031362
Name:OCCUPATIONAL THERAPY ASSOCIATES WAKEFIELD
Entity type:Organization
Organization Name:OCCUPATIONAL THERAPY ASSOCIATES WAKEFIELD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MS
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:BICKLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-245-4446
Mailing Address - Street 1:607 NORTH AVE
Mailing Address - Street 2:DOOR # 14
Mailing Address - City:WAKEFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01880-1307
Mailing Address - Country:US
Mailing Address - Phone:781-245-4446
Mailing Address - Fax:781-245-5505
Practice Address - Street 1:607 NORTH AVE
Practice Address - Street 2:DOOR # 14
Practice Address - City:WAKEFIELD
Practice Address - State:MA
Practice Address - Zip Code:01880-1307
Practice Address - Country:US
Practice Address - Phone:781-245-4446
Practice Address - Fax:781-245-5505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-17
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Single Specialty
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty