Individual
MICHAEL DEZMIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
74 BRIDGE ST, NEWTON, MA 02458-1147
(617) 969-4410
(617) 969-4412
Mailing address
25 ROSE AVE, WATERTOWN, MA 02472-3012
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
11767
MA
Other
Enumeration date
10/12/2015
Last updated
10/12/2015
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