Healthcare Provider Details

I. General information

NPI: 1548233836
Provider Name (Legal Business Name): ALLISON MAY OTRL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALLISON ROBINS

II. Dates (important events)

Enumeration Date: 02/08/2006
Last Update Date: 11/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 QUINCY AVE
QUINCY MA
02169
US

IV. Provider business mailing address

51 WATER ST
WATERTOWN MA
02472-4611
US

V. Phone/Fax

Practice location:
  • Phone: 617-786-8811
  • Fax: 617-786-8877
Mailing address:
  • Phone: 617-744-8300
  • Fax: 617-786-8877

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number9132
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: