Healthcare Provider Details

I. General information

NPI: 1902440308
Provider Name (Legal Business Name): KATHLEEN MARIE AUYEUNG OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHLEEN MARIE MURPHY

II. Dates (important events)

Enumeration Date: 10/30/2019
Last Update Date: 01/18/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 MAIN ST STE A
FARMINGTON CT
06032-2985
US

IV. Provider business mailing address

15 INVERNESS CT
CHESHIRE CT
06410-3548
US

V. Phone/Fax

Practice location:
  • Phone: 860-674-1824
  • Fax: 860-674-1836
Mailing address:
  • Phone: 203-558-2412
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number005260
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: