Provider Demographics
NPI:1235952714
Name:VALLARIO, KATRINA MARIE (MSOT)
Entity type:Individual
Prefix:
First Name:KATRINA
Middle Name:MARIE
Last Name:VALLARIO
Suffix:
Gender:F
Credentials:MSOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 ARCHIBALD AVE
Mailing Address - Street 2:
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-2678
Mailing Address - Country:US
Mailing Address - Phone:978-852-7465
Mailing Address - Fax:
Practice Address - Street 1:76 FORT EDDY RD STE 1
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-7415
Practice Address - Country:US
Practice Address - Phone:603-494-1455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-04
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3880225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist