Individual
MRS. STACEY LORRAINE AMARAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/ L
Contact information
Practice address
347 SOMERVILLE AVE, SOMERVILLE, MA 02143-2914
(617) 201-6076
Mailing address
347 SOMERVILLE AVE, SOMERVILLE, MA 02143-2914
(617) 201-6076
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1940
MA
Other
Enumeration date
07/15/2007
Last updated
07/15/2007
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