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General NPI Number Information
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NPI Number | 1235952714
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Entity Type | Individual
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Provider Name | KATRINA MARIE VALLARIO MSOT
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Gender | Female
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Dates
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Enumeration Date | 11/04/2024
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Last Update Date | 11/04/2024
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Provider Practice Location Address
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Address Line | 76 FORT EDDY RD STE 1
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City | CONCORD
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State | NH
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Zip | 03301-7415
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Country | US
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Telephone | 603-494-1455
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Fax |
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Provider Business Mailing Address
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Address Line | 36 ARCHIBALD AVE
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City | METHUEN
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State | MA
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Zip | 01844-2678
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Country | US
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Telephone | 978-852-7465
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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 | 3880
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License Number State | NH
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