Basic Information
| Provider Information | |||||||||
| NPI: | 1902568611 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BUSHWAY | ||||||||
| FirstName: | EMILY | ||||||||
| MiddleName: | ANN | ||||||||
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| Credential: | OTR/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 55 SLUMBER LN | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 011281315 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4138834128 | ||||||||
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| Practice Location | |||||||||
| Address1: | 95 FRANK B MURRAY ST | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 011031106 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4133016019 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/10/2021 | ||||||||
| LastUpdateDate: | 10/10/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 10/10/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 13989 | MA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.