Provider Demographics
NPI:1285756924
Name:NELSON, MARY ELLEN D (OT L)
Entity type:Individual
Prefix:MRS
First Name:MARY ELLEN
Middle Name:D
Last Name:NELSON
Suffix:
Gender:F
Credentials:OT L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:85 FLEETWOOD PATH
Mailing Address - Street 2:
Mailing Address - City:MARSTONS MILLS
Mailing Address - State:MA
Mailing Address - Zip Code:02648
Mailing Address - Country:US
Mailing Address - Phone:508-428-9454
Mailing Address - Fax:
Practice Address - Street 1:27 PARK ST
Practice Address - Street 2:CAPE CODE HOSPITAL REHABILITATION SERVICES
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601
Practice Address - Country:US
Practice Address - Phone:508-771-1800
Practice Address - Fax:508-862-7345
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4617225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist