Provider Demographics
NPI:1194787325
Name:RETTMAN, TERESA ANNE (OTR/L, CHT)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:ANNE
Last Name:RETTMAN
Suffix:
Gender:F
Credentials:OTR/L, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 NORTH ST STE C
Mailing Address - Street 2:
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-3825
Mailing Address - Country:US
Mailing Address - Phone:508-771-6685
Mailing Address - Fax:508-771-5774
Practice Address - Street 1:130 NORTH ST STE C
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-3825
Practice Address - Country:US
Practice Address - Phone:508-771-6685
Practice Address - Fax:508-771-5774
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2033225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0704822Medicaid
MAAA49825OtherHARVARD PILGRIM
MA000289701Medicare PIN