Individual
CHRISTINE RAVISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
95 LAUREL ST, GREENFIELD, MA 01301-3106
(413) 774-3143
(413) 772-0478
Mailing address
65 S MILL RIVER RD, SOUTH DEERFIELD, MA 01373-9733
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2733
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1053120
CERTIFICATION
—
01
—
2733
ALLIED HEALTH PROFESSIONAL LICENSE
—
Enumeration date
07/04/2008
Last updated
07/04/2008
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