Individual
CHARLENE BETH BOTELHO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
50 MAUDE ST, PROVIDENCE, RI 02908-4325
(401) 456-6451
Mailing address
50 MAUDE ST, PROVIDENCE, RI 02908-4325
(401) 456-6451
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA00480
RI
Other
Enumeration date
11/29/2012
Last updated
11/29/2012
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