Healthcare Provider Details

I. General information

NPI: 1255265294
Provider Name (Legal Business Name): CLAIRE VICTORIA MANSOOR OTD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

179 BEAR HILL RD
WALTHAM MA
02451-1063
US

IV. Provider business mailing address

13 HOWARD ST APT 1
CAMBRIDGE MA
02139-4370
US

V. Phone/Fax

Practice location:
  • Phone: 781-895-9500
  • Fax:
Mailing address:
  • Phone: 781-895-9500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOTL36269
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: