Healthcare Provider Details
I. General information
NPI: 1841256484
Provider Name (Legal Business Name): DEBRA JABLONSKI CARTY OTR L BCP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/22/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
64 BARNABAS RD
NEWTOWN CT
06470-1259
US
IV. Provider business mailing address
60 STATE ROUTE 39
NEW FAIRFIELD CT
06812
US
V. Phone/Fax
- Phone: 203-270-1370
- Fax: 203-270-1417
- Phone: 203-746-7237
- Fax: 203-270-1417
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225XP0200X |
| Taxonomy | Pediatric Occupational Therapist |
| License Number | 1023 |
| License Number State | CT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: