Individual
BIANCA DESOUSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4 RESERVOIR RD, GLOUCESTER, MA 01930-2200
(908) 399-7854
Mailing address
4 RESERVOIR RD, GLOUCESTER, MA 01930-2200
(908) 399-7854
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTL36340
MA
Other
Enumeration date
12/15/2025
Last updated
12/15/2025
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