Individual
ELIZA POPPY GUILBAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L, BS
Contact information
Practice address
12 DANA ST UNIT 1, SOMERVILLE, MA 02145-3001
(978) 504-1379
Mailing address
12 DANA ST UNIT 1, SOMERVILLE, MA 02145-3001
(978) 504-1379
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
4739
MA
Other
Enumeration date
09/30/2024
Last updated
09/30/2024
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