Basic Information
| Provider Information | |||||||||
| NPI: | 1295401446 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SPAULDING | ||||||||
| FirstName: | MARY CLAIRE | ||||||||
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| Credential: | COTA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 36 WOODLAWN AVE APT A4 | ||||||||
| Address2: | |||||||||
| City: | HILLSBORO | ||||||||
| State: | NH | ||||||||
| PostalCode: | 032444890 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6077424906 | ||||||||
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| Practice Location | |||||||||
| Address1: | 50 PHEASANT RD | ||||||||
| Address2: | |||||||||
| City: | PETERBOROUGH | ||||||||
| State: | NH | ||||||||
| PostalCode: | 034582110 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6039247267 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/18/2021 | ||||||||
| LastUpdateDate: | 08/18/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/28/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 224Z00000X | 0861 | NH | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant |
No ID Information.