Provider Demographics
NPI:1083179485
Name:LESPINASSE, MAYA (DPT)
Entity type:Individual
Prefix:DR
First Name:MAYA
Middle Name:
Last Name:LESPINASSE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:MAYA
Other - Middle Name:
Other - Last Name:BOUYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10 PAULA LN
Mailing Address - Street 2:
Mailing Address - City:FOXBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02035-2785
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 CHAUNCY ST STE 4
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:MA
Practice Address - Zip Code:02048-1200
Practice Address - Country:US
Practice Address - Phone:508-339-7999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-10
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
MA24076225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist