Mercedes Rose Desautel, COTA/L

Individual provider Active NPI Occupational Therapy Assistant · North Attleboro, MA

NPI 1265032452 · NPPES record last updated Oct 28, 2020

Key facts

NPI
1265032452
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
3772 (MA)
Practice address
85 N Washington St
North Attleboro, MA 02760-1634
Phone
(508) 699-2740
NPI assigned
Oct 28, 2020
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
00711RIMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 3772 MA Yes
Occupational Therapy Assistant 224Z00000X 00711 RI

Addresses

Primary practice location

85 N Washington St
North Attleboro, MA 02760-1634

Mailing address

2 Englewood Rd
Coventry, RI 02816-5218
Phone (401) 474-6819

Other names

  • Mercedes Bravo Former name

Other providers in North Attleboro, MA

All providers in North Attleboro, MA · Occupational Therapy Assistant in Massachusetts

Sources for this page

Verify at the official NPI Registry.