Jillian Faulkner, COTA/L

Individual provider Active NPI Occupational Therapy Assistant · Wrentham, MA

NPI 1659708402 · NPPES record last updated Oct 10, 2013

Key facts

NPI
1659708402
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
3322 (MA)
Practice address
90 Taunton St
Wrentham, MA 02093-1349
Phone
(508) 384-7977
NPI assigned
Oct 10, 2013
Sex
Female
Sole proprietor
No

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
3322MAMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 3322 MA Yes

Addresses

Primary practice location

90 Taunton St
Wrentham, MA 02093-1349

Mailing address

28 Whitla Dr
Worcester, MA 01604-1348
Phone (508) 816-9058

Other providers in Wrentham, MA

All providers in Wrentham, MA · Occupational Therapy Assistant in Massachusetts

Sources for this page

Verify at the official NPI Registry.