Individual
DIANE LAROSE MAXSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
500 CHAPMAN ST, SUITE 104, CANTON, MA 02021-2093
(781) 821-9955
(781) 821-9950
Mailing address
14 LAWRENCE CIR, MEDFIELD, MA 02052-2825
(508) 359-9893
(781) 821-9950
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
AH 237 OT
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT0092
BLUE CROSS BLUE SHIELD MA
MA
Enumeration date
12/28/2006
Last updated
07/08/2007
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