Healthcare Provider Details

I. General information

NPI: 1750588562
Provider Name (Legal Business Name): ERIN CONNOR OTRL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2007
Last Update Date: 04/25/2025
Certification Date: 04/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 PARK AVE
WORCESTER MA
01609-1953
US

IV. Provider business mailing address

6 HADWEN LN APT 2
WORCESTER MA
01602-2655
US

V. Phone/Fax

Practice location:
  • Phone: 508-847-5529
  • Fax:
Mailing address:
  • Phone: 508-847-5529
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XM0800X
TaxonomyMental Health Occupational Therapist
License Number9175
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number9175
License Number StateMA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: