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Individual

ELIZABETH BEAUDRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
306 LIBERTY ST, ROCKLAND, MA 02370-1355
(617) 548-6778
Mailing address
306 LIBERTY ST, ROCKLAND, MA 02370-1355

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
8472
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
OT0170
BCBS PROVIDER ID
MA
Enumeration date
02/07/2007
Last updated
06/28/2013
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