Individual
MRS. GINA WALTOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
239 LAWRENCE RD, SOUTH WINDSOR, CT 06074-1813
(860) 648-0421
Mailing address
239 LAWRENCE RD, SOUTH WINDSOR, CT 06074-1813
(860) 648-0421
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
000646
CT
Other
Enumeration date
02/10/2012
Last updated
02/10/2012
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