Provider Demographics
NPI:1346051901
Name:ANTHONY, MAIRI KATHRYN (OT R/L)
Entity type:Individual
Prefix:
First Name:MAIRI
Middle Name:KATHRYN
Last Name:ANTHONY
Suffix:
Gender:F
Credentials:OT R/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 SULLIVAN CIR
Mailing Address - Street 2:
Mailing Address - City:STONEHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02180-1452
Mailing Address - Country:US
Mailing Address - Phone:781-799-4494
Mailing Address - Fax:
Practice Address - Street 1:200 UNICORN PARK DR
Practice Address - Street 2:
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-3324
Practice Address - Country:US
Practice Address - Phone:781-782-1366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-14
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA15584225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist