Healthcare Provider Details

I. General information

NPI: 1265773634
Provider Name (Legal Business Name): THE BINA FARM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2013
Last Update Date: 03/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39 MILLER ST
NORFOLK MA
02056-1258
US

IV. Provider business mailing address

207 UNION ST
NATICK MA
01760-6060
US

V. Phone/Fax

Practice location:
  • Phone: 508-651-2462
  • Fax:
Mailing address:
  • Phone: 508-651-2462
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number3628
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number3628
License Number StateMA

VIII. Authorized Official

Name: DIANA LYMAN
Title or Position: OCCUPATIONAL THERAPIST
Credential:
Phone: 781-259-9963