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Individual

GRACE DENIO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
186 JERRY BROWNE RD, MYSTIC, CT 06355-4004
(860) 572-5675
Mailing address
186 JERRY BROWNE RD, MYSTIC, CT 06355-4004

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5796
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5796
OT LICENSE
CT
Enumeration date
02/25/2022
Last updated
02/25/2022
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