Healthcare Provider Details

I. General information

NPI: 1831009687
Provider Name (Legal Business Name): SADIE ARNOLD OTD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 AMORY ST
JAMAICA PLAIN MA
02130-2652
US

IV. Provider business mailing address

555 AMORY ST
JAMAICA PLAIN MA
02130-2652
US

V. Phone/Fax

Practice location:
  • Phone: 617-383-6522
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOTL36879
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: