Individual
ELISABETH GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
888 N MAIN ST, BROCKTON, MA 02301-1668
(508) 587-6556
Mailing address
888 N MAIN ST, BROCKTON, MA 02301-1668
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
9493
MA
Other
Enumeration date
05/22/2014
Last updated
05/22/2014
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