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Individual

MRS. LAUREL WINNICK WAPLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
400 ORANGE CENTER RD, ORANGE, CT 06477-2962
(203) 795-0400
(203) 795-0400
Mailing address
400 ORANGE CENTER RD, ORANGE, CT 06477-2962
(203) 795-0400
(203) 795-0400

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
000086
CT
225XP0200X
Pediatric Occupational Therapist
000086
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000086
STATE LICENSE
CT
Enumeration date
11/20/2007
Last updated
11/20/2007
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