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General NPI Number Information
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NPI Number | 1366964694
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Entity Type | Individual
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Provider Name | GRETA DEVOLDER OTR/L
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Gender | Female
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Dates
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Enumeration Date | 07/07/2017
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Last Update Date | 07/07/2017
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Provider Practice Location Address
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Address Line | 147 PARK AVE
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City | ARLINGTON
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State | MA
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Zip | 02476-5828
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Country | US
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Telephone | 781-648-9530
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Fax |
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Provider Business Mailing Address
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Address Line | 10 FAIRFIELD ST APT 6
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City | BOSTON
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State | MA
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Zip | 02116-1666
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Country | US
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Telephone | 603-244-9950
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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 | 225XP0019X
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Taxonomy Name | Physical Rehabilitation Occupational Therapist
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License Number | 12316
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License Number State | MA
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