Healthcare Provider Details

I. General information

NPI: 1194817940
Provider Name (Legal Business Name): MICHELE A TAFT OTR L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MICHELE A IORIO

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 03/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 SUMMER ST SUITE 320
WORCESTER MA
01605
US

IV. Provider business mailing address

630 PLANTATION ST
WORCESTER MA
01605
US

V. Phone/Fax

Practice location:
  • Phone: 508-368-3140
  • Fax: 508-368-3143
Mailing address:
  • Phone: 508-368-3140
  • Fax: 508-368-3143

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number3254
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: