Individual
MICHELLE LAMOUREUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1000 EDDY STREET, PROVIDENCE, RI 02905
(401) 533-9100
Mailing address
1000 EDDY STREET, PROVIDENCE, RI 02905
(401) 533-9100
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA00204
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2058
RI NHPRC
RI
01
—
640014
RI UNITED
RI
01
—
99947
RI BLUE CROSS
RI
Enumeration date
04/27/2007
Last updated
07/08/2007
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