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Individual

MS. SHERLYN LOUISE FENTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTD,MS, OTR/L

Contact information

Practice address
30 MAN MAR DR, SUITE 9, PLAINVILLE, MA 02762-2271
(617) 640-0400
(617) 658-1049
Mailing address
30 MAN MAR DR, PLAINVILLE, MA 02762-2271
(617) 640-0400
(617) 658-1049

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
2492
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1561
RI STATE LICENSE
RI
01
2492
MA STATE OT LICENSE
MA
01
915892
NBCOT CERTIFICATION
01
OT0055
BCBS
MA
01
S400284607
PTAN
Enumeration date
10/05/2007
Last updated
04/05/2016
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