Individual
MISS MARYELLEN DAIGNEAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
977 MAIN STREET, WALTHAM, MA 02451-7406
(781) 899-4709
(781) 899-4788
Mailing address
135 HIGH STREET, LEOMINSTER, MA 01453
(978) 537-2399
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5500
MA
Other
Enumeration date
04/13/2007
Last updated
07/08/2007
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