Individual
MISS MARISSA EMILY GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
111 ORIENT AVE, EAST BOSTON, MA 02128-1006
(617) 569-2100
Mailing address
19 CUMNER AVE, MELROSE, MA 02176-5016
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
11795
MA
Other
Enumeration date
06/12/2017
Last updated
06/12/2017
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