Healthcare Provider Details

I. General information

NPI: 1235694860
Provider Name (Legal Business Name): PHOEBE PERKINS MOT, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2019
Last Update Date: 04/01/2025
Certification Date: 04/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 CHURCHMANS RD STE 100A
NEWARK DE
19702-1943
US

IV. Provider business mailing address

PO BOX 411422
BOSTON MA
02241-1422
US

V. Phone/Fax

Practice location:
  • Phone: 302-544-5055
  • Fax:
Mailing address:
  • Phone: 866-448-9543
  • Fax: 631-580-5223

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number528372
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: