MEDICARE: MS. TOI LADONNE MOSES OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	06697	MD

General Provider Information

NPI Number	:	1871888727
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TOI LADONNE MOSES OTR/L

Provider Business Mailing Address
First Line	:	633 COOLEY ST
Second Line	:
City	:	SPRINGFIELD
State	:	MA
Zip	:	01128-1115
Country	:	US
Telephone Number	:	413-519-1992
Fax Number	:

Provider Business Practice Location Address
First Line	:	633 COOLEY ST
Second Line	:
City	:	SPRINGFIELD
State	:	MA
Zip	:	01128-1115
Country	:	US
Telephone Number	:	413-519-1992
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/17/2011
Last Update Date	:	06/17/2011

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