Provider Demographics
NPI:1639708068
Name:PLANCHE, EUGENIE VICTOIRE (OT, OTD, OTR)
Entity type:Individual
Prefix:
First Name:EUGENIE
Middle Name:VICTOIRE
Last Name:PLANCHE
Suffix:
Gender:
Credentials:OT, OTD, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 EDGERLY PL APT 404
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116-5327
Mailing Address - Country:US
Mailing Address - Phone:508-314-8964
Mailing Address - Fax:
Practice Address - Street 1:875 MASSACHUSETTS AVE # 4-1
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-3067
Practice Address - Country:US
Practice Address - Phone:617-203-6377
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-07
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAOTL15561225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist