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General NPI Number Information
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NPI Number | 1215168083
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Entity Type | Individual
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Provider Name | CAROLYN M LEVESQUE OTRL
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Gender | Female
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Dates
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Enumeration Date | 07/28/2009
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Last Update Date | 08/08/2018
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Provider Practice Location Address
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Address Line | 25 STONEHAVEN DR
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City | WEYMOUTH
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State | MA
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Zip | 02190
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Country | US
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Telephone | 781-337-3121
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Fax |
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Provider Business Mailing Address
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Address Line | 180 CENTRAL ST
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City | ROCKLAND
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State | MA
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Zip | 02370-2468
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Country | US
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Telephone | 508-380-6873
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 9717
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License Number State | MA
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