Individual
BETTY J DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
63 WORCESTER ST, SOUTHBRIDGE, MA 01550-3407
(774) 230-8641
Mailing address
PO BOX 127, 63 WORCESTER ST, SOUTHBRIDGE, MA 01550-0127
(774) 230-8641
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1756
MA
Other
Enumeration date
03/23/2016
Last updated
03/23/2016
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