Healthcare Provider Details

I. General information

NPI: 1033034483
Provider Name (Legal Business Name): KRYSTAL VICTORIA WINFIELD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 NEW STATE HWY
RAYNHAM MA
02767-5439
US

IV. Provider business mailing address

156 GREELEY ST
PAWTUCKET RI
02861-3128
US

V. Phone/Fax

Practice location:
  • Phone: 508-824-6800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberOTA25067
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: