Individual
DENISE A PELLETIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1000 EDDY STREET, PROVIDENCE, RI 02905
(401) 533-9100
Mailing address
1000 EDDY STREET, PROVIDENCE, RI 02905
(401) 533-9100
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA00264
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2058
SS NHPRC
RI
01
—
6400144
SS UHP
RI
01
—
99947
SS BCROSS
RI
Enumeration date
07/13/2006
Last updated
07/08/2007
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