Individual
THEPDARA BORIBOUN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
245 MAIN ST, WOONSOCKET, RI 02895-3123
(401) 766-0900
(401) 766-8737
Mailing address
3095 MENDON RD, CUMBERLAND, RI 02864-2401
(401) 524-5236
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT00974
RI
Other
Enumeration date
08/11/2009
Last updated
08/11/2009
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