Individual
IMANI PARKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
345 FORTUNE BLVD, MILFORD, MA 01757-1723
(508) 478-2631
Mailing address
345 FORTUNE BLVD, MILFORD, MA 01757-1723
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
13032
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13032
OCCUPATIONAL THERAPY LICENSE
MA
Enumeration date
02/11/2019
Last updated
05/08/2020
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