Individual
THERESA C LUDDECKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
26 SHENIPSIT LAKE RD, TOLLAND, CT 06084-2332
(860) 872-2999
Mailing address
26 SHENIPSIT LAKE RD, TOLLAND, CT 06084
(860) 872-2999
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
371
CT
Other
Enumeration date
02/23/2012
Last updated
02/29/2012
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