Provider Demographics
NPI:1588870828
Name:HAYES, COLEEN DEBORAH (COTA)
Entity type:Individual
Prefix:
First Name:COLEEN
Middle Name:DEBORAH
Last Name:HAYES
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:COLEEN
Other - Middle Name:DEBORAH
Other - Last Name:BRYANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA
Mailing Address - Street 1:60 GORMAN RD
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-8006
Mailing Address - Country:US
Mailing Address - Phone:617-872-1360
Mailing Address - Fax:
Practice Address - Street 1:136 BOSTON POST RD
Practice Address - Street 2:
Practice Address - City:SUDBURY
Practice Address - State:MA
Practice Address - Zip Code:01776-2406
Practice Address - Country:US
Practice Address - Phone:617-789-3258
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2014-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2314224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant