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Individual

MRS. THERESA ELLEN WHITFORD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
10 BELLAMY ST, BRIGHTON, MA 02135-1502
(617) 782-8113
(617) 779-4033
Mailing address
65 UNION ST, WATERTOWN, MA 02472-2523
(617) 966-3367

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2813
MA

Other

Enumeration date
06/18/2008
Last updated
06/18/2008
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