Healthcare Provider Details

I. General information

NPI: 1760240519
Provider Name (Legal Business Name): EMILY ANNE BUTLER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: EMILY ANNE DOWNING

II. Dates (important events)

Enumeration Date: 03/07/2024
Last Update Date: 03/07/2024
Certification Date: 03/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3285 S COUNTY TRL UNIT 2B
EAST GREENWICH RI
02818-1469
US

IV. Provider business mailing address

65 UNION ST APT 2
WOONSOCKET RI
02895-5349
US

V. Phone/Fax

Practice location:
  • Phone: 401-404-5585
  • Fax:
Mailing address:
  • Phone: 774-286-1853
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT01922
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number13715
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: