Individual
MISS SHANTILLE MARIE DERIGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
179 BEAR HILL RD, WALTHAM, MA 02451-1063
(781) 895-9500
Mailing address
549 CENTRE ST APT 4, NEWTON, MA 02458-2067
(951) 212-1496
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
13454
MA
Other
Enumeration date
11/16/2021
Last updated
11/16/2021
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