Individual
IRENE KERSHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
163 LIBBEY INDUSTRIAL PKWY, SUITE 302, WEYMOUTH, MA 02189-3137
(781) 335-6663
Mailing address
64 CONSTITUTION RD, CHARLESTOWN, MA 02129-2038
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
220
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT0190
BCBS PROVIDER ID
MA
Enumeration date
02/07/2007
Last updated
07/08/2007
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