Individual
LISA CAROLYN MANDELBLATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7 HARTWELL ST, WALTHAM, MA 02453-8907
(617) 388-7439
Mailing address
7 HARTWELL ST, WALTHAM, MA 02453-8907
(617) 388-7439
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
5527
MA
Other
Enumeration date
01/29/2007
Last updated
07/08/2007
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