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Individual
MRS. ELLEN JULIA RADFORD
Active
Individual
MRS. ELLEN JULIA RADFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
10510
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10510
DIVISION OF PROFESSIONAL LICENSURE BOARD OF ALLIED HEALTH PROFESSIONS
MA
01
—
290947
NBCOT
—
Enumeration date
07/31/2013
Last updated
07/31/2013
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