Healthcare Provider Details

I. General information

NPI: 1720907306
Provider Name (Legal Business Name): SERENA MORA OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 FOREST RIDGE DR
ROWLEY MA
01969-2150
US

IV. Provider business mailing address

14 JAMBRAY AVE
WARWICK RI
02886-0745
US

V. Phone/Fax

Practice location:
  • Phone: 978-356-0315
  • Fax:
Mailing address:
  • Phone: 401-406-0436
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number36727
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: