Individual
AMY ELIZABETH VILLALOBOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT/R
Contact information
Practice address
16 CONVERSE CIR, EAST LONGMEADOW, MA 01028-1906
(413) 847-1212
Mailing address
16 CONVERSE CIR, EAST LONGMEADOW, MA 01028-1906
(413) 847-1212
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
12191
MA
225XG0600X
Gerontology Occupational Therapist
Primary
12191
MA
225XN1300X
Neurorehabilitation Occupational Therapist
16542658
CT
225XP0200X
Pediatric Occupational Therapist
900839666
MA
Other
Enumeration date
09/07/2016
Last updated
04/29/2021
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