Individual
LESLIE OLUVEIRA BAGANHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL CEIS
Contact information
Practice address
1563 N MAIN STREET, SUITE 208, FALL RIVER, MA 02720
(508) 324-1060
(508) 679-8590
Mailing address
20 WATER STREET, BERKLEY, MA 02779
(508) 823-8399
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
7751
MA
Other
Enumeration date
12/26/2006
Last updated
07/08/2007
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