Provider Demographics
NPI:1770574469
Name:EKELUND, CHERYL HARWOOD (MS, OTR/L)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:HARWOOD
Last Name:EKELUND
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:CHERYL
Other - Middle Name:
Other - Last Name:HARWOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10 JEAN AVE
Mailing Address - Street 2:SUITE 10
Mailing Address - City:CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01824-1739
Mailing Address - Country:US
Mailing Address - Phone:978-441-9452
Mailing Address - Fax:978-454-9292
Practice Address - Street 1:10 JEAN AVE
Practice Address - Street 2:SUITE 10
Practice Address - City:CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01824-1739
Practice Address - Country:US
Practice Address - Phone:978-441-9452
Practice Address - Fax:978-454-9292
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8437225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAUX2265Medicare PIN