Provider Demographics
NPI:1588375059
Name:YAWITZ, ALYSON (OTD, OTR/L)
Entity type:Individual
Prefix:DR
First Name:ALYSON
Middle Name:
Last Name:YAWITZ
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1340 COMMONWEALTH AVE APT 9
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02134-3922
Mailing Address - Country:US
Mailing Address - Phone:314-556-3214
Mailing Address - Fax:
Practice Address - Street 1:33 TOWER ST
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02143-1426
Practice Address - Country:US
Practice Address - Phone:617-591-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-06
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA14673225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist