Basic Information
Provider Information
NPI: 1083934491
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FABER
FirstName: MARIA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: OT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 110 HAVERHILL RD
Address2: SUITE 401
City: AMESBURY
State: MA
PostalCode: 019132123
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 110 HAVERHILL RD
Address2: SUITE 401
City: AMESBURY
State: MA
PostalCode: 019132123
CountryCode: US
TelephoneNumber: 9783884500
FaxNumber: 9783888255
Other Information
ProviderEnumerationDate: 06/08/2010
LastUpdateDate: 06/08/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000X9791MAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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