Healthcare Provider Details

I. General information

NPI: 1245967421
Provider Name (Legal Business Name): ALLISON KOBIELSKI OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2022
Last Update Date: 08/06/2022
Certification Date: 08/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

490 BOSTON POST RD
SUDBURY MA
01776-3367
US

IV. Provider business mailing address

490 BOSTON POST RD
SUDBURY MA
01776-3367
US

V. Phone/Fax

Practice location:
  • Phone: 978-631-3201
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number14440
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: