Individual
VANNIDA LORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
200 GOVERNORS AVE, MEDFORD, MA 02155-1644
(781) 391-5400
Mailing address
19901 BRAMBLE BUSH DR, GAITHERSBURG, MD 20879-1613
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
13105
MA
Other
Enumeration date
05/19/2019
Last updated
05/19/2019
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