Individual
MARISSA L LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
444 WASHINGTON ST, SUITE 401, WOBURN, MA 01801-1046
(781) 937-9777
Mailing address
741 E 6TH ST, APT #22, SOUTH BOSTON, MA 02127-4372
(617) 359-4133
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3080
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
161216796
TAX ID
MA
Enumeration date
03/06/2009
Last updated
03/06/2009
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