Provider Demographics
NPI:1902658982
Name:DOWD, SHANNON BRIDGET (OTR/L)
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:BRIDGET
Last Name:DOWD
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 WORCESTER RD
Mailing Address - Street 2:
Mailing Address - City:HUBBARDSTON
Mailing Address - State:MA
Mailing Address - Zip Code:01452-1142
Mailing Address - Country:US
Mailing Address - Phone:978-434-7069
Mailing Address - Fax:
Practice Address - Street 1:31 HAYWARD ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:MA
Practice Address - Zip Code:02038-2166
Practice Address - Country:US
Practice Address - Phone:203-458-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-03
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAOTL15006225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics