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Individual

SALIMATA CISSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
352 DANA FARMS, FAIRHAVEN, MA 02719-3360
(774) 226-6713
Mailing address
352 DANA FARMS, FAIRHAVEN, MA 02719-3360
(774) 226-6713

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
14288
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
EIN
INTERNAL REVENUE SERVICE (IRS)
Enumeration date
01/17/2022
Last updated
03/18/2022
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