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Individual

JESSICA BOUTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSOTR/L, WCC

Contact information

Practice address
940 BELMONT ST, BROCKTON, MA 02301-5568
(774) 826-1811
Mailing address
117 THURLOW ST, GEORGETOWN, MA 01833-1132
(978) 430-5367

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
11366
MA
225X00000X
Occupational Therapist
2433
NH
225X00000X
Occupational Therapist
332720
MA

Other

Enumeration date
10/04/2017
Last updated
03/27/2020
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