Healthcare Provider Details

I. General information

NPI: 1568790228
Provider Name (Legal Business Name): SKILLS 4 SENIORS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2009
Last Update Date: 12/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43 NYLANDER WAY
ACTON MA
01720-3568
US

IV. Provider business mailing address

43 NYLANDER WAY
ACTON MA
01720-3568
US

V. Phone/Fax

Practice location:
  • Phone: 978-929-9298
  • Fax:
Mailing address:
  • Phone: 978-929-9298
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XG0600X
TaxonomyGerontology Occupational Therapist
License Number6931
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code225XL0004X
TaxonomyLow Vision Occupational Therapist
License Number6931
License Number StateMA

VIII. Authorized Official

Name: MS. SUSAN TOBY EPPLING
Title or Position: OCCUPATIONAL THERAPIST
Credential: MS, OTR/L
Phone: 978-929-9298