Healthcare Provider Details

I. General information

NPI: 1922406636
Provider Name (Legal Business Name): ELIZABETH RALPHS OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2014
Last Update Date: 01/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

67 DAVIS RD
DRACUT MA
01826-2911
US

IV. Provider business mailing address

67 DAVIS RD
DRACUT MA
01826-2911
US

V. Phone/Fax

Practice location:
  • Phone: 888-531-2204
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number10192
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: