Healthcare Provider Details

I. General information

NPI: 1891173167
Provider Name (Legal Business Name): NATALEE ROLINCE PENDER OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2015
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 TABOR XING
LONGMEADOW MA
01106-1779
US

IV. Provider business mailing address

191 WOODMONT ST
WEST SPRINGFIELD MA
01089-2347
US

V. Phone/Fax

Practice location:
  • Phone: 413-567-7800
  • Fax:
Mailing address:
  • Phone: 774-254-4234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number11564
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: