Provider Demographics
NPI:1215492947
Name:HIMMER, REESE MORGAN (OT)
Entity type:Individual
Prefix:MR
First Name:REESE
Middle Name:MORGAN
Last Name:HIMMER
Suffix:
Gender:M
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 BERKLEY ST
Mailing Address - Street 2:
Mailing Address - City:MARLBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01752-3205
Mailing Address - Country:US
Mailing Address - Phone:339-368-3588
Mailing Address - Fax:
Practice Address - Street 1:11 BERKLEY ST
Practice Address - Street 2:
Practice Address - City:MARLBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01752-3205
Practice Address - Country:US
Practice Address - Phone:339-368-3588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-06
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA11620225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist