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General NPI Number Information
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NPI Number | 1457682254
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Entity Type | Organization
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Legal Business Name | DOREEN KRUGER
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Dates
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Enumeration Date | 01/19/2010
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Last Update Date | 01/19/2010
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Provider Practice Location Address
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Address Line | 10 BIRCHWOOD DR
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City | HUNTINGTON
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State | MA
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Zip | 01050-9623
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Country | US
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Telephone | 413-297-4057
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Fax | 413-207-3042
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Provider Business Mailing Address
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Address Line | 10 BIRCHWOOD DR
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City | HUNTINGTON
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State | MA
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Zip | 01050-9623
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Country | US
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Telephone | 413-297-4057
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Fax | 413-207-3042
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Authorized Official
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Title or Position | OWNER
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Name | DOREEN KRUGER
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Credential |
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Telephone | 413-297-4057
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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 | 6487
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License Number State | MA
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