Individual
MRS. HEATHER LYNN PARENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1132 MERIDEN RD, WATERBURY, CT 06705-3629
(203) 757-1228
Mailing address
1233 SPINDLE HILL RD, WOLCOTT, CT 06716-1200
(203) 558-8855
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
001039
CT
Other
Enumeration date
08/10/2013
Last updated
08/10/2013
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