Individual
MR. MATTHEW PATRICK MCKENNA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
62 LEWIS RD, BELMONT, MA 02478
(617) 484-8921
Mailing address
62 LEWIS RD, BELMONT, MA 02478
(617) 484-8921
Taxonomy
Speciality
Code
Description
License number
State
225CA2400X
Assistive Technology Practitioner Rehabilitation Counselor
Primary
8949
MA
Other
Enumeration date
05/16/2007
Last updated
07/08/2007
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