Individual
MS. ALYSE C BYNUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3101
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0331881
—
MA
01
—
2358775
AETNA US/HEALTHCARE
MA
01
—
OT0006
BLUE CROSS BLUE SHIELD
MA
Enumeration date
11/30/2005
Last updated
04/19/2013
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