Healthcare Provider Details

I. General information

NPI: 1942882832
Provider Name (Legal Business Name): ERIN M HEYL OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ERIN M FARRELL

II. Dates (important events)

Enumeration Date: 04/21/2021
Last Update Date: 05/02/2021
Certification Date: 05/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 COTTAGE CT APT 8
NEWTON MA
02458-1272
US

IV. Provider business mailing address

12 COTTAGE CT APT 8
NEWTON MA
02458-1272
US

V. Phone/Fax

Practice location:
  • Phone: 617-763-4734
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number13929
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: