Individual
AMANDA ROSE FAMULARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
74 BRIDGE ST, NEWTON, MA 02458-1147
(617) 969-4410
Mailing address
64 PERCIVAL ST APT 3, BOSTON, MA 02122-1984
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
13384
MA
Other
Enumeration date
11/27/2019
Last updated
11/27/2019
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