Basic Information
Provider Information | |||||||||
NPI: | 1548652613 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | MASON | ||||||||
FirstName: | ERIN | ||||||||
MiddleName: | L | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | M. OT, O.T. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: | LOBB | ||||||||
OtherFirstName: | ERIN | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: | O.T. | ||||||||
OtherLastNameType: | 1 | ||||||||
Mailing Information | |||||||||
Address1: | 1 CREDIT UNION WAY FL 3 | ||||||||
Address2: |   | ||||||||
City: | RANDOLPH | ||||||||
State: | MA | ||||||||
PostalCode: | 023684633 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7819613370 | ||||||||
FaxNumber: | 7819611291 | ||||||||
Practice Location | |||||||||
Address1: | 1095 WASHINGTON ST | ||||||||
Address2: |   | ||||||||
City: | ATTLEBORO | ||||||||
State: | MA | ||||||||
PostalCode: | 027037944 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 5087615945 | ||||||||
FaxNumber: | 5087619111 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 02/26/2015 | ||||||||
LastUpdateDate: | 12/31/2018 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X |   |   | N |   | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |   | 225X00000X | 12840 | MA | Y |   | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |   |
No ID Information.