Healthcare Provider Details

I. General information

NPI: 1831621820
Provider Name (Legal Business Name): ALINA LILLIS OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2017
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

198 CHARLTON RD STE 10
STURBRIDGE MA
01566-1571
US

IV. Provider business mailing address

198 CHARLTON RD STE 10
STURBRIDGE MA
01566-1571
US

V. Phone/Fax

Practice location:
  • Phone: 774-241-3905
  • Fax: 774-241-3906
Mailing address:
  • Phone: 774-241-3905
  • Fax: 774-241-3906

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number13389
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: