Healthcare Provider Details

I. General information

NPI: 1558008540
Provider Name (Legal Business Name): BRIDGET HALLE MS, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2022
Last Update Date: 12/11/2023
Certification Date: 12/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 WASHINGTON ST STE P55
NORWELL MA
02061-1742
US

IV. Provider business mailing address

60 PATTISON ST APT C13
ABINGTON MA
02351-1855
US

V. Phone/Fax

Practice location:
  • Phone: 781-290-3886
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number12818
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: