Individual
CHARLENE E COSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
2270 MAIN ST, ATHOL, MA 01331
(978) 906-1254
Mailing address
58 NORTHERN AVE, ATHOL, MA 01331
(978) 906-1254
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
AH-0T-5222
MA
Other
Enumeration date
12/14/2023
Last updated
12/14/2023
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